Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore.
Support Care Cancer. 2021 Dec;29(12):7237-7248. doi: 10.1007/s00520-021-06102-2. Epub 2021 Jul 8.
This systematic review aimed to synthesize the effectiveness of psychosocial interventions on caregivers of advanced cancer patients, in comparison with usual care, on caregivers' quality of life (QoL), anxiety, and depression symptoms.
Comprehensive searches for published and unpublished studies were performed using nine electronic databases, two trial registers, and reference lists of included studies. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias tool was used to appraise the methodological quality of included studies, while the Cochrane data extraction tool was used to elicit relevant information. Meta-analysis, narrative analysis, and sensitivity analysis were conducted to synthesize data. Standardized mean differences (SMD) represented effects of psychosocial interventions.
Fifteen randomized controlled trials were included in this review. At post-intervention, findings revealed a significant small pooled effect size (SMD = 0.45) on QoL and significant moderate effect on depression (SMD = - 0.65). However, a small non-significant pooled effect size was observed on anxiety (SMD = - 0.24). At follow-up assessments, effect sizes of all outcomes were small and non-significant. Overall quality of evidence was rated very low for all outcomes and most studies had unclear or high risk of bias. Thus, results should be interpreted with caution.
Psychosocial interventions were effective in improving QoL and depression among caregivers of persons with advanced cancer. However, future randomized control trials with lower risk of bias, larger sample size, detailed participant characteristics, and informative interventions are desirable.
本系统评价旨在综合心理社会干预对晚期癌症患者照顾者的效果，与常规护理相比，对照顾者的生活质量（QoL）、焦虑和抑郁症状的影响。
使用九个电子数据库、两个试验登记处和纳入研究的参考文献列表，全面搜索已发表和未发表的研究。两名审查员独立筛选、评估和提取数据。使用 Cochrane 偏倚风险工具评估纳入研究的方法学质量，同时使用 Cochrane 数据提取工具获取相关信息。进行荟萃分析、叙述性分析和敏感性分析以综合数据。标准化均数差（SMD）表示心理社会干预的效果。
本综述纳入了 15 项随机对照试验。在干预后，研究结果显示，生活质量的合并效应大小有显著的小（SMD = 0.45），抑郁的合并效应大小有显著的中（SMD = -0.65）。然而，焦虑的合并效应大小较小且无统计学意义（SMD = -0.24）。在随访评估中，所有结局的效应大小均较小且无统计学意义。所有结局的总体证据质量均被评为极低，且大多数研究存在偏倚不明确或高风险。因此，结果应谨慎解释。
心理社会干预对改善晚期癌症患者照顾者的生活质量和抑郁有一定效果。然而，未来需要开展具有更低偏倚风险、更大样本量、详细参与者特征和有信息的干预措施的随机对照试验。
