Luo Jing, Li Lixiang, Reangsing Chuntana, Schneider Joanne Kraenzle
School of Nursing, Guizhou Medical University, The Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, China.
Trudy Busch Valentine School of Nursing, Saint Louis University, MO, St. Louis, USA.
Int J Behav Med. 2022 Dec;29(6):691-704. doi: 10.1007/s12529-021-10051-9. Epub 2022 Feb 8.
Although psychotherapy is a common treatment for hopelessness and hope, the effectiveness remains controversial. The purpose of this study was to quantitatively synthesize available evidence related to the effect of a broad range of psychotherapy interventions on hope/hopelessness in cancer patients.
Eight electronic databases were searched for studies with adult cancer patients (mean age ≥ 18 years) receiving psychotherapy interventions with hope/hopelessness measured as outcomes and written in English. We used the random-effects model to compute effect size using Hedges' g and conducted moderator analyses.
We found 27 primary studies which included 1,998 participants who were 57.6 ± 8.0 years old across studies. The psychotherapy effect size ranged from - 0.86 to 2.92. Researchers who conducted psychotherapy at hospital/health centers showed higher effects, that is, improved hope scores (g = 0.63), than those who conducted psychotherapy in the community (g = 0.05). When researchers enrolled participants alone, psychotherapy resulted in higher effects (g = 0.62) than when partners/caregivers were involved (g = - 0.04). Researchers who included group discussion showed lower effects (g = 0.36) than without group discussion (g = 1.10). Researchers who examined fidelity found lower effects (g = 0.16) than researchers who did not examine fidelity (g = 0.66). Interestingly, researchers who studied people with breast cancer showed higher effects (g = 0.96) than those who studied people with other types of cancer (g = 0.26). Researchers who included higher percentages of women showed greater effects (slope = 0.008, Q = 3.99, p = 0.046). Finally, the greater the time span between psychotherapy and the measurement of hope, the lower the psychotherapy effects (slope = - 0.002, Q = 4.25, p = 0.039).
Psychotherapy had a solid moderate effect on reducing hopelessness and improving hope in cancer patients compared to controls.
尽管心理治疗是治疗绝望和希望的常用方法，但其有效性仍存在争议。本研究的目的是定量综合一系列心理治疗干预措施对癌症患者希望/绝望影响的现有证据。
检索八个电子数据库，查找针对成年癌症患者（平均年龄≥18岁）接受心理治疗干预且以希望/绝望作为结局指标并以英文撰写的研究。我们使用随机效应模型，采用赫奇斯g值计算效应量，并进行调节因素分析。
我们发现了27项主要研究，这些研究共纳入1998名参与者，各研究中参与者的年龄为57.6±8.0岁。心理治疗的效应量范围为-0.86至2.92。在医院/健康中心进行心理治疗的研究人员显示出更高的效应，即希望得分有所提高（g = 0.63），高于在社区进行心理治疗的研究人员（g = 0.05）。当研究人员单独招募参与者时，心理治疗的效应（g = 0.62）高于有伴侣/照顾者参与时（g = -0.04）。纳入小组讨论的研究人员显示的效应（g = 0.36）低于未纳入小组讨论的研究人员（g = 1.10）。检查治疗保真度的研究人员显示的效应（g = 0.16）低于未检查治疗保真度的研究人员（g = 0.66）。有趣的是，研究乳腺癌患者的研究人员显示的效应（g = 0.96）高于研究其他类型癌症患者的研究人员（g = 0.26）。纳入女性比例更高的研究人员显示出更大的效应（斜率 = 0.008，Q = 3.99，p = 0.046）。最后，心理治疗与希望测量之间的时间跨度越大，心理治疗的效应越低（斜率 = -0.002，Q = 4.25，p = 0.039）。
与对照组相比，心理治疗在降低癌症患者的绝望感和提高希望方面有可靠的中等效果。
