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癌症患者的物质使用和物质使用障碍的系统评价。

A systematic review of substance use and substance use disorders in patients with cancer.

机构信息

Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, United States; Harvard Medical School, Department of Psychiatry, Boston, MA 02115, United States.

Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, United States; Harvard Medical School, Department of Psychiatry, Boston, MA 02115, United States.

出版信息

Gen Hosp Psychiatry. 2019 Sep-Oct;60:128-136. doi: 10.1016/j.genhosppsych.2019.04.016. Epub 2019 Apr 26.

Abstract

OBJECTIVE

Few studies examined substance use in cancer patients. The aims of this systematic review were to summarize this evidence, identify methodological limitations, and provide future research directions.

METHOD

Articles on substance use in cancer (focused on illicit substance, opioid, and alcohol use) were searched in Medline, PsycINFO, and PsycARTICLES.

RESULTS

On the basis of inclusion criteria, 28 studies were reviewed. Twenty-one contained empiric data from 500,123 participants; seven were review or conceptual papers. All studies were published between 1995 and 2018. Quality assessment revealed relatively low risk of bias and high methodological quality. Five studies examined substance use or substance use disorder (SUD) broadly. Mean ages ranged from 17.6 to 74.7 years. Substance use rates ranged from 2% to 35%, with a median opioid rate of 18% and 25.5% for alcohol. Nine of the studies had samples comprised either mostly or exclusively of advanced cancer patients. Disease groups included breast, head & neck, and gastric cancer. None of the studies used a theoretical framework or model.

CONCLUSIONS

Given the prevalence of substance use in cancer patients, interventions are needed. Further theory-grounded studies are warranted to foster the translation of research into clinical practice and elucidate substance use management recommendations.

摘要

目的

很少有研究调查癌症患者的物质使用情况。本系统评价的目的是总结这方面的证据,确定方法学上的局限性,并为未来的研究提供方向。

方法

在 Medline、PsycINFO 和 PsycARTICLES 中搜索了关于癌症患者物质使用(重点是非法物质、阿片类药物和酒精使用)的文章。

结果

根据纳入标准,共审查了 28 项研究。其中 21 项包含了来自 500123 名参与者的实证数据;7 项是综述或概念性论文。所有研究均发表于 1995 年至 2018 年之间。质量评估显示,偏倚风险相对较低,方法学质量较高。有 5 项研究广泛调查了物质使用或物质使用障碍(SUD)。平均年龄范围从 17.6 岁到 74.7 岁。物质使用率从 2%到 35%不等,阿片类药物的中位数率为 18%,酒精的中位数率为 25.5%。有 9 项研究的样本主要或完全由晚期癌症患者组成。疾病组包括乳腺癌、头颈部癌和胃癌。没有一项研究使用理论框架或模型。

结论

鉴于癌症患者物质使用的普遍性,需要采取干预措施。进一步进行基于理论的研究是必要的,以促进研究向临床实践的转化,并阐明物质使用管理建议。

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