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前列腺癌幸存者患者报告的泌尿系统症状的干预措施:系统评价

Intervention for patient reported urinary symptoms in prostate cancer survivors: Systematic review.

作者信息

Kim Kisook, Kim Ji-Su

机构信息

Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea.

出版信息

J Cancer Surviv. 2017 Oct;11(5):643-654. doi: 10.1007/s11764-017-0637-9. Epub 2017 Aug 22.

Abstract

PURPOSE

Prostate cancer survivors can experience poor quality of life (QoL) due to urinary symptoms. Accordingly, studies on the effects of various symptom management methods for improving subjective urinary symptoms and the QoL of prostate cancer survivors have been actively conducted. This study aimed to evaluate the effects of subjective measurement of symptom management interventions for patients with prostate cancer receiving treatment.

METHODS

We used PubMed, EMBASE, CINAHL, PsycInfo, and Cochrane Library CENTRAL to systematically search for randomized controlled trials published in English, through January 2017.

RESULTS

We found and systematically reviewed 14 studies for symptom management intervention content, mode of delivery, session, and provider. We then conducted a meta-analysis of seven randomized controlled trials involving 846 participants, comparing symptom management with usual care. There was a small but statistically significant improvement in subjective urinary symptoms (d = -0.32, 95% CI [-0.47, -0.19], p < 0.001, I  = 30.3%), but QoL was not statistically significant. A subgroup analysis by intervention type and start time found statistically significant effects on subjective urinary symptoms.

CONCLUSIONS

Symptom management interventions had small but statistically significant effects on urinary symptoms. However, the present findings should be interpreted with caution considering the number of studies with limited conclusions.

IMPLICATIONS FOR CANCER SURVIVORS

Pre-/post-prostatectomy symptom management intervention may be recommended as a nursing intervention to improve symptom management in prostate cancer survivors. However, more research should be conducted to identify the most effective symptom management intervention.

摘要

目的

前列腺癌幸存者可能因泌尿系统症状而生活质量较差。因此,关于各种症状管理方法对改善前列腺癌幸存者主观泌尿系统症状及生活质量影响的研究一直在积极开展。本研究旨在评估对接受治疗的前列腺癌患者进行症状管理干预的主观测量效果。

方法

我们利用PubMed、EMBASE、CINAHL、PsycInfo和Cochrane图书馆CENTRAL系统检索截至2017年1月以英文发表的随机对照试验。

结果

我们查找并系统回顾了14项关于症状管理干预内容、实施方式、疗程和提供者的研究。然后,我们对7项涉及846名参与者的随机对照试验进行了荟萃分析,比较了症状管理与常规护理。主观泌尿系统症状有小幅但具有统计学意义的改善(d = -0.32,95% CI [-0.47, -0.19],p < 0.001,I² = 30.3%),但生活质量无统计学意义。按干预类型和开始时间进行的亚组分析发现,对主观泌尿系统症状有统计学意义的影响。

结论

症状管理干预对泌尿系统症状有小幅但具有统计学意义的影响。然而,考虑到研究数量有限且结论有限,目前的研究结果应谨慎解读。

对癌症幸存者的启示

前列腺切除术前/后的症状管理干预可作为一种护理干预措施推荐,以改善前列腺癌幸存者的症状管理。然而,应开展更多研究以确定最有效的症状管理干预措施。

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