1 Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong.
2 Jockey Club End-of-Life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong.
Palliat Med. 2017 Dec;31(10):883-894. doi: 10.1177/0269216317705101. Epub 2017 May 10.
Life review interventions have been used to alleviate psycho-spiritual distress in people near the end of life. However, their effectiveness remains inconclusive.
To evaluate the effects of therapeutic life review on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer.
A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology.
Five databases were searched from their respective inception through February 2017 for relevant randomized controlled trials. The effects of therapeutic life review were pooled across the trials. Standardized mean differences were calculated for the pooled effects. Heterogeneity was assessed using the I test. Study quality was assessed using the Cochrane criteria.
Eight randomized controlled trials met the inclusion criteria. The pooled results suggested a desirable effect of therapeutic life review on the meaning of life domain of spiritual well-being (standardized mean difference = 0.33; 95% confidence interval, 0.12 to 0.53), general distress (standardized mean difference = -0.32; 95% confidence interval, -0.55 to -0.09), and overall quality of life (standardized mean difference = 0.35; 95% confidence interval, 0.15 to 0.56) when compared to usual care only. Of the three outcomes examined, only the pooled effect on overall quality of life remained statistically significant at follow-ups up to 3 months after the intervention (standardized mean difference = 0.82; 95% confidence interval, 0.47 to 1.18).
Therapeutic life review is potentially beneficial for people near the end of life. However, the results should be interpreted with caution due to the limited number of randomized controlled trials and associated methodological weaknesses. Further rigorously designed randomized controlled trials are warranted.
生命回顾干预已被用于缓解生命末期患者的心理-精神困扰。然而，其疗效仍不确定。
评估治疗性生命回顾对终末期或晚期癌症患者的精神幸福感、心理困扰和生活质量的影响。
根据系统评价和荟萃分析的首选报告项目进行系统评价。
从每个数据库的建立到 2017 年 2 月，共检索了 5 个数据库，以寻找相关的随机对照试验。跨试验汇总了治疗性生命回顾的效果。计算了汇总效果的标准化均数差。使用 I 检验评估异质性。使用 Cochrane 标准评估研究质量。
8 项随机对照试验符合纳入标准。汇总结果表明，治疗性生命回顾对精神幸福感的生活意义领域（标准化均数差=0.33；95%置信区间，0.12 至 0.53）、一般困扰（标准化均数差=-0.32；95%置信区间，-0.55 至 -0.09）和总体生活质量（标准化均数差=0.35；95%置信区间，0.15 至 0.56）有良好的效果，与仅常规护理相比。在检查的三个结果中，只有干预后 3 个月内的总体生活质量的汇总效果仍具有统计学意义（标准化均数差=0.82；95%置信区间，0.47 至 1.18）。
治疗性生命回顾对生命末期的人可能是有益的。然而，由于随机对照试验数量有限和相关方法学缺陷，结果应谨慎解释。需要进一步进行严格设计的随机对照试验。
