Laboratory for Psycho-oncology Research, University of Notre Dame, Notre Dame, IN, USA.
Quantitative Methods, Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, USA.
Palliat Med. 2021 Apr;35(4):710-728. doi: 10.1177/0269216321994728. Epub 2021 Mar 30.
The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases.
To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome.
This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956).
Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies.
Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( = 0.61, 95% confidence interval (CI) = 0.28-0.93) but did not significantly reduce hopelessness ( = -0.08, 95% CI = -0.18 to 0.02). It was found that interventions significantly increase spirituality ( = 0.70, 95% CI = 0.02-1.37) and decrease depression ( = -0.29, 95% CI = -0.51 to -0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low.
Evidence suggests that interventions can be effective in increasing hope in palliative care patients.
希望是慢性病和姑息治疗中的一个重要主题，与增强心理-精神幸福感和生活质量有关。在这一人群中已经描述了心理-精神干预措施，但尚未对姑息治疗疾病患者的增强希望干预措施或减少绝望干预措施进行系统评价。
描述和评估姑息治疗中以希望和（或）绝望为结果的干预措施的效果。
本系统评价和荟萃分析预先注册（前瞻性 ID：CRD42019119956）。
电子数据库、期刊和参考文献进行了检索。我们使用 Cochrane 标准评估研究内的偏倚风险。
共纳入 35 项研究（24 项随机对照试验、5 项准实验、6 项前后研究），共纳入 3296 名姑息治疗患者。与单独常规/标准癌症护理相比，干预措施显著提高了希望水平，中等效应量为 0.61（95%置信区间 [CI]：0.28-0.93），但并未显著降低绝望感（ = -0.08，95% CI：-0.18 至 0.02）。研究发现，干预措施显著提高了灵性（ = 0.70，95% CI：0.02-1.37），降低了抑郁（ = -0.29，95% CI：-0.51 至 -0.07），但对焦虑、生活质量和症状负担没有显著影响。总体而言，纳入研究的证据质量等级均为低。
有证据表明，干预措施可以有效提高姑息治疗患者的希望。
