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电子健康干预措施对癌症患者非专业照护者的照护负担、抑郁和生活质量的影响:一项随机对照试验的系统评价和荟萃分析。

The effectiveness of e-Health interventions on caregiver burden, depression, and quality of life in informal caregivers of patients with cancer: A systematic review and meta-analysis of randomized controlled trials.

机构信息

West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou district, Chengdu, Sichuan, PR China.

West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou district, Chengdu, Sichuan, PR China.

出版信息

Int J Nurs Stud. 2022 Mar;127:104179. doi: 10.1016/j.ijnurstu.2022.104179. Epub 2022 Jan 17.

Abstract

BACKGROUND

With the increasing incidence and survival rate of cancer, there are more people living with cancer, which increases the responsibilities of informal caregivers and results in a significant caregiver burden, depression, and low quality of life. The efficacy of e-Health interventions has already been proven in decreasing caregiver burden, addressing psychosocial concerns, and increasing quality of life among caregivers of patients with chronic diseases. However, the utilization of e-Health interventions on the informal caregivers of cancer patients is still limited and the effectiveness is unclear.

OBJECTIVES

To assess the impact of e-Health interventions on the caregiver burden, depression, and quality of life of informal caregivers of cancer patients.

METHODS

A literature search was conducted in six electronic databases (PubMed, EMBASE, Web of Science, CENTRAL, PsycInfo, and CINAHL Plus with Full Text) from the inception of the databases to 31 May 2021. Two authors independently screened the studies and extracted the data. Cochrane's bias risk tool for randomized controlled trials was used to examine the methodological quality of the included studies. The intervention effect was estimated by calculating the standard mean difference (SMD) and 95% confidence interval (CI) with Review Manager 5.3. A sensitivity analysis was conducted to test the robustness of the pooled results.

RESULTS

Seven randomized controlled trials with 326 participants were included in the review. The results of the meta-analysis showed that e-Health interventions could significantly improve the depression (SMD = -0.90, 95% CI [-1.76∼-0.04], P = 0.04) and quality of life (SMD = 0.45, 95% CI [0.13∼0.77], P = 0.006), but not caregiver burden (SMD = -0.29, 95% CI [-0.61∼0.02], P = 0.07) in informal caregivers. Sensitivity analysis showed that only the caregiver burden was stable.

CONCLUSION

e-Health interventions are a convenient method to support the informal caregivers of cancer patients, and can mitigate depression and enhance the quality of life of informal caregivers, but had no significant effect on easing the caregiver burden. In future, tailored e-Health intervention, based on informal caregivers' demographic characteristics and cultural context, is warranted to improve informal caregivers' well-being.

REGISTRATION NUMBER

CRD42021250253 (PROSPERO).

摘要

背景

随着癌症发病率和存活率的不断提高,越来越多的人患有癌症,这增加了非正式照顾者的责任,导致照顾者负担过重、抑郁和生活质量下降。电子健康干预措施在减轻照顾者负担、解决心理社会问题以及提高慢性病患者照顾者的生活质量方面已经显示出了疗效。然而,电子健康干预措施在癌症患者非正式照顾者中的应用仍然有限,其效果尚不清楚。

目的

评估电子健康干预措施对癌症患者非正式照顾者的照顾者负担、抑郁和生活质量的影响。

方法

从六个电子数据库(PubMed、EMBASE、Web of Science、CENTRAL、PsycInfo 和 CINAHL Plus with Full Text)中进行了文献检索,检索时间从数据库建立到 2021 年 5 月 31 日。两位作者独立筛选研究并提取数据。使用 Cochrane 偏倚风险工具评估纳入研究的方法学质量。干预效果通过计算标准均数差(SMD)和 95%置信区间(CI)用 Review Manager 5.3 进行估计。进行敏感性分析以检验汇总结果的稳健性。

结果

纳入了 7 项随机对照试验,共 326 名参与者。荟萃分析结果表明,电子健康干预措施可以显著改善抑郁(SMD=-0.90,95%CI[-1.76∼-0.04],P=0.04)和生活质量(SMD=0.45,95%CI[0.13∼0.77],P=0.006),但对非正式照顾者的照顾者负担(SMD=-0.29,95%CI[-0.61∼0.02],P=0.07)没有显著影响。敏感性分析表明,只有照顾者负担是稳定的。

结论

电子健康干预措施是一种方便的方法,可以支持癌症患者的非正式照顾者,减轻他们的抑郁情绪,提高他们的生活质量,但对减轻照顾者负担没有显著影响。未来,需要根据非正式照顾者的人口统计学特征和文化背景,制定量身定制的电子健康干预措施,以提高非正式照顾者的幸福感。

注册号

CRD42021250253(PROSPERO)。

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