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认知行为疗法对乳腺癌患者生活质量的影响:随机对照试验的系统评价和荟萃分析。

The effect of cognitive behavioral therapy on the quality of life of breast cancer patients: a systematic review and meta-analysis of randomized controlled trials.

机构信息

School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.

The First Affiliated Teaching Hospital of Zhengzhou University, Zhengzhou, Henan, China.

出版信息

Qual Life Res. 2021 Feb;30(2):367-384. doi: 10.1007/s11136-020-02665-5. Epub 2020 Oct 17.

Abstract

PURPOSE

Several lines of clinical research support the efficacy of Cognitive behavioral therapy (CBT) with a large number of population and various disease conditions, however, the true effects of CBT interventions on Quality of Life of breast cancer patients remain unknown. The aim of the study was to evaluate the effect of Cognitive Behavioral Therapy on the Quality of Life of breast cancer patients.

METHODS

A systematic review of articles published using Web of Science (1950-January 2020); Medline via EBSCO (1992-January 2020); Science direct via ELSEVIER (1996-January 2020); SCOPUS (2004-January 2020); and PubMed (1946-January 2020 excluding Medline from 1992-January 2020) were included. Additional studies were included after  checking reference lists of all relevant studies; searching ongoing trials and research registers and manual search. Data extraction was conducted by two independent authors and a third independent author checked the data extraction. The PRISMA statement was adopted.

RESULT

Eleven Randomized controlled trials (RCT) with 1690 breast cancer patients were included in this review. The overall effect size of cognitive behavioral therapy on QoL of breast cancer patients was medium 0.39 (95% CI 0.12-0.66, P < 0.00001, I = 83%). Five studies had shown statistically significant improvement in functional and symptoms scales in the treatment group than the control group.

CONCLUSION

CBT is effective in improving the Quality of Life of breast cancer patients. In future research, further randomized controlled trials with adequate randomization, allocation concealment, and appropriate blinding may be needed.

摘要

目的

有许多临床研究支持认知行为疗法(CBT)的疗效,涉及大量人群和各种疾病,但 CBT 干预对乳腺癌患者生活质量的真正影响尚不清楚。本研究旨在评估认知行为疗法对乳腺癌患者生活质量的影响。

方法

系统检索 Web of Science(1950 年 1 月至 2020 年 1 月)、EBSCO 旗下 Medline(1992 年 1 月至 2020 年 1 月)、ELSEVIER 旗下 Science direct(1996 年 1 月至 2020 年 1 月)、SCOPUS(2004 年 1 月至 2020 年 1 月)和 PubMed(1946 年 1 月至 2020 年 1 月,不包括 1992 年 1 月至 2020 年 1 月的 Medline),纳入的文献包括文献综述和临床试验注册。通过查看所有相关研究的参考文献列表、搜索正在进行的试验和研究登记处以及手动搜索,进一步纳入了额外的研究。两位作者独立进行数据提取,第三位作者检查数据提取情况。本研究采用 PRISMA 声明。

结果

本综述纳入了 11 项随机对照试验(RCT),共 1690 例乳腺癌患者。认知行为疗法对乳腺癌患者生活质量的总体效应量为中等 0.39(95% CI 0.12-0.66,P<0.00001,I=83%)。五项研究表明,治疗组在功能和症状量表上的改善程度明显优于对照组。

结论

CBT 可有效改善乳腺癌患者的生活质量。在未来的研究中,可能需要进一步开展随机对照试验,以确保充分的随机化、分配隐藏和适当的盲法。

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