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癌症患儿家属的心理干预治疗:系统评价和荟萃分析。

Psychological treatment for family members of children with cancer: A systematic review and meta-analysis.

机构信息

Faculty of Psychology, University of Murcia (Spain), Murcia.

出版信息

Psychooncology. 2019 May;28(5):960-969. doi: 10.1002/pon.5052. Epub 2019 Mar 18.

Abstract

OBJECTIVE

This meta-analytical study examined the effects of psychological treatments applied to family members of children and adolescents with cancer, as well as the characteristics of the studies that can be associated with their effects.

METHODS

Four databases were searched between January 1980 and January 2017; the references of the located studies were reviewed, and emails were sent to experts in this topic. Forty articles fulfilled the selection criteria. The standardized mean pretest-posttest (or pretest-follow-up) change was used as the effect-size index for the treatment and control groups.

RESULTS

The 40 articles included 40 treatment groups and 21 control groups. When treatment and control pretest-posttest mean effects were compared, psychological interventions revealed positive, statistically significant results for anxiety (d  = 0.339) and problem-solving skills (d  = 0.385) and, to a lesser extent, for posttraumatic stress (d  = 0.224). No statistically significant differences were found for mood (d  = 0.147), acute stress (d  = -0.010), coping skills (d  = 0.123), social support (d  = 0.245), or quality of life (d  = 0.538).

CONCLUSIONS

Positive effects of mild to moderate magnitude were found in the posttests for some outcome measures. Behavioral interventions seem to be the most promising. Interventions achieved the best results when they were long in duration and low in intensity and when they were applied to family members with young children who were undergoing medical treatment. At follow-up, the intervention benefits were diminished. The application of psychological interventions is recommended to mitigate the negative psychological repercussions in this population.

摘要

目的

本荟萃分析研究考察了应用于儿童和青少年癌症患者家属的心理治疗的效果,以及与这些效果相关的研究特征。

方法

在 1980 年 1 月至 2017 年 1 月期间检索了四个数据库;查阅了定位研究的参考文献,并向该主题的专家发送了电子邮件。四十篇文章符合选择标准。使用治疗组和对照组的标准化平均预处理后测(或预处理-随访)变化作为效应大小指数。

结果

这 40 篇文章包括 40 个治疗组和 21 个对照组。当比较治疗组和对照组的预处理后测均值效应时,心理干预对焦虑(d = 0.339)和解决问题技能(d = 0.385)显示出积极的、统计学上显著的效果,而创伤后应激的效果则较小(d = 0.224)。在情绪(d = 0.147)、急性应激(d = -0.010)、应对技能(d = 0.123)、社会支持(d = 0.245)或生活质量(d = 0.538)方面,没有发现统计学上的显著差异。

结论

在一些结果测量的后测中发现了中等程度的积极效果。行为干预似乎最有前途。当干预持续时间长、强度低,并且应用于正在接受医疗治疗的有年幼子女的家庭成员时,干预效果最佳。在随访时,干预的益处减少。建议应用心理干预来减轻该人群的负面心理影响。

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