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正念干预在癌症患者和幸存者中的有效性:系统评价和荟萃分析。

The effectiveness of mindfulness-based interventions among cancer patients and survivors: a systematic review and meta-analysis.

机构信息

Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.

Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.

出版信息

Support Care Cancer. 2020 Apr;28(4):1563-1578. doi: 10.1007/s00520-019-05219-9. Epub 2019 Dec 13.

Abstract

PURPOSE

Cancer is one of the leading causes of morbidity and mortality worldwide. Cancer negatively affects individuals' quality of life and overall health. Mindfulness-based interventions appear to be promising in the reduction of cancer-related and treatment-related symptoms. This review aimed to systematically summarize and synthesize the best available evidence concerning the effectiveness of mindfulness-based interventions on anxiety, depression, quality of life, fatigue, stress, posttraumatic growth, and mindfulness among adult cancer patients and survivors.

METHODS

A literature search was conducted across 10 electronic databases. Only randomized controlled trials were eligible. Two reviewers independently screened the studies, extracted data, and performed quality assessment using the Cochrane risk of bias assessment tool. Meta-analyses were conducted using review manager software, and standardized mean difference (SMD) was used to determine intervention effects. Subgroup analyses were performed for cancer type, gender, and interventions. Heterogeneity was examined using the Chi and I statistics.

RESULTS

Twenty-nine studies were included with a total of 3476 participants. Those who received mindfulness-based interventions reported significantly lower anxiety, depression, fatigue, and stress and greater quality of life, posttraumatic growth, and mindfulness than respondents in control groups. Mindfulness-based art therapy (MBAT) produced the strongest intervention effect on anxiety (SMD = - 2.48) and depression (SMD = - 2.21), followed by mindfulness-based stress reduction program (MBSR) and mindfulness-based care recovery (MBCR). The interventions were effective across different cancer types.

CONCLUSION

Mindfulness-based interventions can be used as an adjuvant therapy for the management of cancer-related symptoms among cancer patients and survivors.

摘要

目的

癌症是全球发病率和死亡率的主要原因之一。癌症会对个人的生活质量和整体健康产生负面影响。基于正念的干预措施似乎在减轻与癌症相关的和治疗相关的症状方面具有很大的潜力。本综述旨在系统地总结和综合现有关于正念干预对成年癌症患者和幸存者的焦虑、抑郁、生活质量、疲劳、压力、创伤后成长和正念的最佳证据。

方法

在 10 个电子数据库中进行了文献检索。只有随机对照试验符合条件。两名审查员独立筛选研究、提取数据,并使用 Cochrane 风险偏倚评估工具进行质量评估。使用评论经理软件进行荟萃分析,使用标准化均数差(SMD)来确定干预效果。进行了亚组分析,分析了癌症类型、性别和干预措施。使用 Chi 和 I 统计检验异质性。

结果

共纳入 29 项研究,共 3476 名参与者。与对照组相比,接受正念干预的人报告的焦虑、抑郁、疲劳和压力显著降低,生活质量、创伤后成长和正念明显更高。正念艺术疗法(MBAT)对焦虑(SMD = -2.48)和抑郁(SMD = -2.21)的干预效果最强,其次是正念减压方案(MBSR)和正念关怀康复(MBCR)。这些干预措施在不同的癌症类型中均有效。

结论

正念干预可以作为癌症患者和幸存者管理癌症相关症状的辅助治疗方法。

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