Kruizinga Renske, Hartog Iris D, Jacobs Marc, Daams Joost G, Scherer-Rath Michael, Schilderman Johannes B A M, Sprangers Mirjam A G, Van Laarhoven Hanneke W M
Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Psychooncology. 2016 Mar;25(3):253-65. doi: 10.1002/pon.3910. Epub 2015 Aug 10.
The aim of this study was to examine the effect of spiritual interventions on quality of life of cancer patients.
We conducted our search on June 6, 2014 in Medline, PsycINFO, Embase, and PubMed. All clinical trials were included that compared standard care with a spiritual intervention that addressed existential themes using a narrative approach. Study quality was evaluated by the Cochrane Risk of Bias Tool.
A total of 4972 studies were identified, of which 14 clinical trials (2050 patients) met the inclusion criteria, and 12 trials (1878 patients) were included in the meta-analysis. The overall risk of bias was high. When combined, all studies showed a moderate effect (d) 0.50 (95% CI = 0.20-0.79) 0-2 weeks after the intervention on overall quality of life in favor of the spiritual interventions. Meta-analysis at 3-6 months after the intervention showed a small insignificant effect (0.14, 95% CI = -0.08 to 0.35). Subgroup analysis including only the western studies showed a small effect of 0.17 (95% CI = 0.05-0.29). Including only studies that met the allocation concealment criteria showed an insignificant effect of 0.14 (95% CI = -0.05 to 0.33).
Directly after the intervention, spiritual interventions had a moderate beneficial effect in terms of improving quality of life of cancer patients compared with that of a control group. No evidence was found that the interventions maintained this effect up to 3-6 months after the intervention. Further research is needed to understand how spiritual interventions could contribute to a long-term effect of increasing or maintaining quality of life.
本研究旨在探讨精神干预对癌症患者生活质量的影响。
我们于2014年6月6日在Medline、PsycINFO、Embase和PubMed数据库进行检索。纳入所有将标准护理与采用叙事方法处理生存主题的精神干预进行比较的临床试验。采用Cochrane偏倚风险工具评估研究质量。
共识别出4972项研究，其中14项临床试验（2050例患者）符合纳入标准，12项试验（1878例患者）纳入荟萃分析。总体偏倚风险较高。综合来看，所有研究显示干预后0至2周对总体生活质量有中度影响（d=0.50，95%CI=0.20-0.79），支持精神干预。干预后3至6个月的荟萃分析显示影响较小且无统计学意义（0.14，95%CI=-0.08至0.35）。仅包括西方研究的亚组分析显示有0.17的小影响（95%CI=0.05-0.29）。仅包括符合分配隐藏标准的研究显示有0.14的无统计学意义的影响（95%CI=-0.05至0.33）。
与对照组相比，干预后立即进行的精神干预在改善癌症患者生活质量方面有中度有益影响。没有证据表明干预在干预后3至6个月能维持这种效果。需要进一步研究以了解精神干预如何有助于长期提高或维持生活质量。
