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妇科癌症女性及其照护者生存干预试验的系统文献回顾。

A systematic literature review of trials of survivorship interventions for women with gynaecological cancer and their caregivers.

机构信息

Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.

School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.

出版信息

Eur J Cancer Care (Engl). 2019 May;28(3):e13057. doi: 10.1111/ecc.13057. Epub 2019 Apr 24.

Abstract

Core components of survivorship care include treatment of late and long-term effects, care coordination, promotion of psychological well-being, health and addressing special populations' needs. Women affected by gynaecological cancer and their caregivers can experience disease-specific issues. This review presents an overview of survivorship interventions that have been trialled among this population. Databases were searched in October/November 2016 to identify eligible studies. Titles, abstracts then full-text were assessed for inclusion by two reviewers until consensus was reached. Data were abstracted using standard tables. Study quality was independently appraised. Twenty-eight articles were included (five reviews; 23 trials). In regards to late and long-term treatment effects, our review found mounting high-level evidence for the effectiveness of psycho-educational programmes to improve physical aspects of sexual function and for exercise interventions for reducing fatigue. We also found emerging evidence for nurse-led follow-up care to improve care coordination and cognitive behavioural therapy to improve psychological wellbeing. There were gaps in the evidence for interventions to effectively address psychosexual issues specific to gynaecological cancer and needs of caregivers. Further research is required to explore strategies to improving psychosexual concerns after gynaecological cancer and the dynamics and supportive care needs of the patient-partner dyad.

摘要

生存护理的核心内容包括治疗晚期和长期影响、护理协调、促进心理幸福感、健康以及满足特殊人群的需求。受妇科癌症影响的女性及其护理人员可能会遇到特定于疾病的问题。本综述介绍了针对这一人群进行的生存干预措施。2016 年 10 月/11 月,我们在数据库中搜索了符合条件的研究。两名评审员评估了标题、摘要和全文,直到达成共识。使用标准表格提取数据。独立评估研究质量。共纳入 28 篇文章(5 篇综述;23 项试验)。关于晚期和长期治疗效果,我们的综述发现,心理教育计划改善性功能的身体方面和运动干预减少疲劳方面的有效性有越来越多的高水平证据。我们还发现,护士主导的随访护理可以改善护理协调,认知行为疗法可以改善心理健康。针对妇科癌症特有的心理性问题和护理人员需求的干预措施的证据还存在空白。需要进一步研究以探索改善妇科癌症后心理性问题的策略,以及患者-伴侣对的动态和支持性护理需求。

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