社会差异人群的非药物性癌症疼痛干预措施：一项系统评价与荟萃分析
Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis.
作者信息
Santos Salas Anna, Fuentes Contreras Jorge, Armijo-Olivo Susan, Saltaji Humam, Watanabe Sharon, Chambers Thane, Walter Lori, Cummings Greta G
机构信息
Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
Department of Physiotherapy, Faculty of Health Sciences, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile.
出版信息
Support Care Cancer. 2016 Feb;24(2):985-1000. doi: 10.1007/s00520-015-2998-9. Epub 2015 Nov 10.
INTRODUCTION
Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances.
RESEARCH PURPOSE
A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender.
METHODS
Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled.
RESULTS
The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts.
CONCLUSION
Results show the need to examine supportive care interventions particularly in populations with social disparities.
引言
全球在疼痛缓解方面取得的进展改善了癌症患者群体的生活质量。然而，与主流群体相比，在存在社会差异的人群中发现了癌症疼痛结果的差异。存在社会差异的人群，如少数民族、低收入个体以及处于弱势环境的女性，承受着资源分配不均的问题。
研究目的
对针对收入、种族或性别存在社会差异的癌症患者群体进行非药物性癌症疼痛干预效果的系统评价和荟萃分析。
方法
通过全面的多数据库检索，以随机对照试验、对照试验以及前后对照研究为目标。两名评审员独立筛选标题/摘要以寻找潜在相关研究，并审查相关文章的全文以确定是否纳入。数据由一名评审员从纳入研究中提取，并由另一名评审员进行核实。四名评审员独立完成质量评估。研究按干预措施进行分组。对效应进行异质性评估并合并。
结果
检索发现5219条潜在记录。对26份报告的全文进行了评估。三项随机对照试验符合纳入标准，针对少数民族、服务不足人群和/或女性。干预措施包括教育、指导和在线支持小组。研究发现干预组与对照组之间或少数民族与其对应人群之间在疼痛减轻方面无显著差异。所有研究均发现存在高偏倚风险。荟萃分析发现，在服务不足人群、少数民族之间或少数民族与白人对应人群之间，疼痛强度在统计学上无显著差异。
结论
结果表明有必要对支持性护理干预措施进行研究，尤其是在存在社会差异的人群中。
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