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基于正念的干预对癌症幸存者疲劳的影响:随机对照试验的系统评价和荟萃分析。

Effects of mindfulness-based interventions on fatigue in cancer survivors: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Indiana University School of Medicine, Regenstrief Institute, Indianapolis, IN, USA.

Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA.

出版信息

Crit Rev Oncol Hematol. 2021 Apr;160:103290. doi: 10.1016/j.critrevonc.2021.103290. Epub 2021 Mar 4.

Abstract

This systematic review and meta-analysis was designed to determine the efficacy of mindfulness-based interventions (MBIs) in improving fatigue-related outcomes in adult cancer survivors. Randomized controlled trials (RCTs) were identified from PubMed, MEDLINE, PsycINFO, CINAHL, Web of Science, and EMBASE databases and reference lists of included studies. Separate random-effects meta-analyses were conducted for fatigue and vitality/vigor. Twenty-three studies reporting on 21 RCTs (N = 2239) met inclusion criteria. MBIs significantly reduced fatigue compared to controls at post-intervention (g = 0.60, 95 % CI [0.36, 0.83]) and first follow-up (g = 0.42, 95 % CI [0.20, 0.64]). Likewise, MBIs significantly improved vitality/vigor at post-intervention (g = 0.39, 95 % CI [0.25, 0.52]) and first follow-up (g = 0.35, 95 % CI [0.03, 0.67]). The evidence grade was low due to risk of bias, substantial heterogeneity, and publication bias among studies. MBIs show promise in improving fatigue and vitality/vigor in cancer survivors. More rigorous trials are needed to address current gaps in the evidence base.

摘要

本系统评价和荟萃分析旨在确定基于正念的干预措施(MBIs)在改善成年癌症幸存者与疲劳相关结局方面的疗效。从 PubMed、MEDLINE、PsycINFO、CINAHL、Web of Science 和 EMBASE 数据库以及纳入研究的参考文献列表中确定了随机对照试验(RCT)。分别对疲劳和活力/活力进行了随机效应荟萃分析。有 23 项研究报告了 21 项 RCT(N=2239)符合纳入标准。与对照组相比,MBIs 在干预后(g=0.60,95%置信区间[0.36,0.83])和第一次随访(g=0.42,95%置信区间[0.20,0.64])时显著降低了疲劳。同样,MBIs 在干预后(g=0.39,95%置信区间[0.25,0.52])和第一次随访(g=0.35,95%置信区间[0.03,0.67])时显著改善了活力/活力。由于研究中的偏倚风险、高度异质性和发表偏倚,证据等级较低。MBIs 在改善癌症幸存者的疲劳和活力/活力方面显示出一定的前景。需要更严格的试验来解决当前证据基础中的差距。

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