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头颈部癌症患者的心理干预措施的系统评价。

A systematic review of psychological interventions for patients with head and neck cancer.

机构信息

Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.

Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

出版信息

Support Care Cancer. 2019 Jun;27(6):2007-2021. doi: 10.1007/s00520-019-04768-3. Epub 2019 Apr 1.

Abstract

AIM

The purpose of this systematic review is to identify psychological interventions that have been effective at improving quality of life and reducing psychological distress (depression and anxiety) in patients with head and neck cancer.

METHODS

All relevant peer-reviewed articles published between March 1980 and March 2017 were identified through an electronic search of five databases: Medline, Embase, PsycINFO, Scopus, and Academic Search Complete. Risk of bias was independently assessed by two reviewers using the Crowe Critical Appraisal Tool (CCAT). Following this, a narrative synthesis of the findings was completed.

RESULTS

Twenty-one unique intervention studies were identified. Interventions tested included cognitive behavioural therapy (CBT), psychoeducation, meditation/mindfulness, group therapy, and telehealth initiatives. Ten studies utilised a randomised controlled design. Five of these investigated CBT and three examined psychoeducation, with the greatest empirical support found for these intervention types. However, the majority of studies were underpowered to detect significant effects and did not examine whether improvements in quality of life and psychological well-being were sustained over time.

CONCLUSIONS

Further research is needed to investigate the effects of psychological interventions among patients with head and neck cancer, using randomised controlled designs, adequately powered samples, and long-term follow-up. This would allow evidence-based recommendations to be made regarding the most appropriate interventions to implement in clinical practice.

TRIAL REGISTRATION

CRD42017069851.

摘要

目的

本系统评价旨在确定能够有效改善头颈部癌症患者生活质量和减轻心理困扰(抑郁和焦虑)的心理干预措施。

方法

通过对五个数据库(Medline、Embase、PsycINFO、Scopus 和 Academic Search Complete)进行电子检索,确定了 1980 年 3 月至 2017 年 3 月期间发表的所有相关同行评议文章。两位评审员使用 Crowe 批判性评估工具(CCAT)独立评估偏倚风险。之后,完成了对研究结果的叙述性综合分析。

结果

确定了 21 项独特的干预研究。测试的干预措施包括认知行为疗法(CBT)、心理教育、冥想/正念、小组治疗和远程医疗计划。其中 10 项研究采用了随机对照设计。其中 5 项研究调查了 CBT,3 项研究调查了心理教育,这两种干预类型得到了最大的实证支持。然而,大多数研究的样本量不足,无法检测到显著效果,也没有研究生活质量和心理幸福感的改善是否能持续较长时间。

结论

需要进一步研究头颈部癌症患者的心理干预措施,采用随机对照设计、足够大的样本量和长期随访,以便能够对头颈部癌症患者提出最适合实施的干预措施的循证建议。

试验注册

CRD42017069851。

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