Kühne F, Meinders C, Mohr H, Hafenbrack K, Kieseritzky K, Rosenberger C, Härter M, Schulz-Kindermann F, Klinger R, Nestoriuc A Y
Abteilung für Klinische Psychologie und Psychotherapie, Universität Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Deutschland.
Arbeitsbereich Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hamburg, Hamburg, Deutschland.
Schmerz. 2016 Dec;30(6):496-509. doi: 10.1007/s00482-016-0169-7.
In cancer patients, pain is one of the main symptoms and especially in the late stages of disease, these symptoms can be associated with considerable suffering. In psycho-oncology, preliminary psychological therapies targeting cancer pain have been tested; however, a systematic review of available interventions is lacking, especially considering their dissemination, evidence base, study quality, and the comparison with established treatments. Therefore, the aim of the current study is to systematically review the current research on psychological treatments for pain in cancer patients.
During May 2014, MEDLINE, PsycINFO, PSYNDEX, and CENTRAL databases were searched. Psychological treatments for pain in adult cancer patients studied in randomized, controlled trials (RCTs) and referring to pain as primary or secondary outcome were included. After examination for inclusion, structured data extraction and assessment followed. Data were synthesized narratively.
In the review, 32 RCTs were included. Studies mainly referred to patients with breast cancer or patients in earlier stages of the disease. The methodological quality of included studies was heterogeneous. Most commonly, short interventions were delivered by nurses in out-patient settings. Interventions including education and relaxation techniques were utilized most often, followed by interventions with behavioral or cognitive components.
A need for research persists regarding efficacy of current psychotherapeutic interventions, or the role of mediator variables (e. g., coping) on pain perception in cancer patients. Studies with high methodological quality which comprehensively and transparently report on interventions and designs are lacking.
在癌症患者中，疼痛是主要症状之一，尤其是在疾病晚期，这些症状可能会带来相当大的痛苦。在心理肿瘤学领域，针对癌症疼痛的初步心理治疗已得到测试；然而，目前缺乏对现有干预措施的系统综述，特别是在干预措施的传播、证据基础、研究质量以及与既定治疗方法的比较方面。因此，本研究的目的是系统综述目前关于癌症患者疼痛心理治疗的研究。
2014年5月，检索了MEDLINE、PsycINFO、PSYNDEX和CENTRAL数据库。纳入在随机对照试验（RCT）中研究的成年癌症患者疼痛的心理治疗，且将疼痛作为主要或次要结局指标。纳入检查后，进行结构化数据提取和评估。数据采用叙述性综合分析。
本综述纳入了32项随机对照试验。研究主要涉及乳腺癌患者或疾病早期患者。纳入研究的方法学质量参差不齐。最常见的情况是，由护士在门诊环境中提供短期干预。最常采用的干预措施包括教育和放松技巧，其次是具有行为或认知成分的干预措施。
目前关于心理治疗干预措施的疗效，或中介变量（如应对方式）在癌症患者疼痛感知中的作用，仍有研究需求。缺乏方法学质量高且全面、透明地报告干预措施和设计的研究。
