1 Palliative Care Research Department, Cabrini Institute, Cabrini Health, Melbourne, VIC, Australia.
2 Palliative Care Service, Cabrini Health, Prahran, VIC, Australia.
Palliat Med. 2018 Jan;32(1):172-184. doi: 10.1177/0269216317722123. Epub 2017 Aug 8.
Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice.
To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety.
MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existential intervention studies in advanced cancer patients published from 1990 to December 2016. Two reviewers independently screened titles and abstracts and assessed relevant studies for eligibility. Data were then extracted from included studies for analysis.
Nine unique quantitative studies were identified, including five randomised controlled trials, involving a total overall of 1179 advanced cancer patients. All studies were psychotherapeutic in nature and centred on existential themes such as meaning, dignity, relationships and spiritual well-being. The therapies investigated shared overlapping themes but varied in duration, therapist experience, training required and burden on patient. Heterogeneity of studies and measures prevented determination of an overall effect size.
Interventions were identified for this clinical scenario of death anxiety in patients with advanced cancer. Therapies of short duration incorporating spiritual well-being and those evoking a sense of meaning were claimed to be the most beneficial, despite lacking rigorous statistical analysis. More high-quality studies with tailored outcome measures are required to fully evaluate the most effective interventions for death anxiety in patients with advanced cancer.
死亡焦虑是晚期癌症成年患者中常见的问题，会对生活质量和临终关怀产生重大影响。目前已有干预措施可以帮助缓解死亡焦虑，但在日常实践中很少使用。
评估针对晚期癌症伴死亡焦虑的成年患者的干预措施的定量研究。
检索 MEDLINE、PsycINFO、Embase 和 CINAHL，以确定从 1990 年至 2016 年 12 月发表的关于死亡焦虑或相关存在主义干预研究的定量或混合研究。两名审查员独立筛选标题和摘要，并评估相关研究的合格性。然后从纳入的研究中提取数据进行分析。
确定了 9 项独特的定量研究，其中包括 5 项随机对照试验，共涉及 1179 例晚期癌症患者。所有研究均具有心理治疗性质，以存在主义主题为中心，如意义、尊严、人际关系和精神健康。所调查的疗法具有重叠的主题，但在持续时间、治疗师经验、所需培训和患者负担方面存在差异。研究和措施的异质性使得无法确定总体效应大小。
针对晚期癌症患者的死亡焦虑这一临床情况，已经确定了干预措施。尽管缺乏严格的统计分析，但持续时间较短的包含精神健康和唤起意义感的疗法被认为最有益。需要更多具有针对性的结局测量的高质量研究来全面评估对晚期癌症患者死亡焦虑最有效的干预措施。
