Grimmett Chloe, Heneka Nicole, Chambers Suzanne
School of Health Sciences, University of Southampton, Southampton, UK.
Faculty of Health, University of Technology Sydney, Sydney, Australia.
Curr Anesthesiol Rep. 2022;12(1):78-87. doi: 10.1007/s40140-021-00505-x. Epub 2022 Jan 31.
Patients with cancer who have high levels of psychological distress have poor treatment compliance and worse outcomes. This "review of reviews" provides a narrative synthesis of the impact of psychological prehabilitation interventions on individuals awaiting cancer surgery.
Twenty reviews of prehabilitation with psychological interventions were identified. There is a trend towards improved psychological outcomes following intervention, particularly when psychologist-led. However, there was considerable heterogeneity within interventions, outcome measures, and timing of assessment precluding numeric synthesis. Methodological limitations including non-blinding, absence of stratification, and underpowered studies were also pervasive.
Providing psychological support early in the cancer pathway and prior to surgery has the potential to improve psychological health and outcomes. The application of existing knowledge in psycho-oncology, including distress screening, is needed in the prehabilitation setting. Consistent outcome assessments, accurate reporting of intervention components and delivery methods, and a consideration of effective systems and economical implementation strategies would facilitate advancements in this field.
The online version contains supplementary material available at 10.1007/s40140-021-00505-x.
心理困扰程度高的癌症患者治疗依从性差且预后更差。本“综述之综述”对心理预康复干预措施对等待癌症手术患者的影响进行了叙述性综合分析。
共确定了20项关于心理干预预康复的综述。干预后有心理状况改善的趋势,尤其是在由心理学家主导的情况下。然而,干预措施、结局指标和评估时间存在相当大的异质性,无法进行数值综合分析。方法学上的局限性,包括未设盲、未分层以及研究效能不足等也普遍存在。
在癌症治疗过程早期及手术前提供心理支持有可能改善心理健康状况和预后。在预康复环境中需要应用心理肿瘤学的现有知识,包括痛苦筛查。一致的结局评估、准确报告干预成分和实施方法,以及考虑有效的系统和经济的实施策略将有助于该领域的进展。
在线版本包含可在10.1007/s40140-021-00505-x获取的补充材料。