The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; Department of Paediatric and Child Health Nursing, College of Health Sciences, Debre Markos University, Ethiopia.
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
J Psychosom Res. 2022 Jun;157:110805. doi: 10.1016/j.jpsychores.2022.110805. Epub 2022 Mar 30.
This systematic review aimed to summarise the effects of cognitive-behavioural therapy on psychological, physical and social outcomes of children with cancer without limitations on publication date.
Thirteen English and seven Chinese electronic databases were searched from April to June 2021. Randomised control trials, quasi-experimental studies, pre-test post-test studies with a control group, factorial or cross-over designs that included children ≤18 years old and during various stages of the cancer trajectory, who have received cognitive-behavioural therapy, and reported (anxiety, depression, stress, quality of life, self-efficacy, fatigue, pain, behavioural distress, anger, and/or academic performance) were included.
Eight studies with quality of evidence ranging from low to high risk of bias were included. The results show cognitive-behavioural therapy has favourable effects on anxiety, depression, pain and behavioural distress. The meta-analysis also show that it reduces anxiety (SMD = -0.89, 95% CI (-1.45, -0.32), p < 0.002), depression (SMD = -0.90, 95% CI (-1.40, -0.39), p < 0.0005), and pain (SMD = -0.56, 95% CI (-1.04, -0.08), p < 0.002). It also has a favourable effect on stress, anger and self-efficacy, though the results are drawn from a single study.
Cognitive-behavioural therapy has the potential to reduce anxiety, depression and pain for children with cancer. It also shows promise in reducing behavioural distress. Although effects on stress, anger, and self-efficacy have been found to be significant, there have been limited studies on these aspects of functioning and more research is needed. The findings are drawn from heterogeneous participants and interventions, thus emphasising the need to conduct well-designed intervention studies, including cancer survivors.
本系统评价旨在综述认知行为疗法对癌症儿童心理、生理和社会结局的影响,对发表日期不设限制。
2021 年 4 月至 6 月,检索了 13 个英文数据库和 7 个中文数据库。纳入的研究类型包括:随机对照试验、准实验研究、有对照组的前后测研究、析因或交叉设计,研究对象为≤18 岁且处于癌症病程各个阶段的儿童,他们接受了认知行为疗法,并报告了(焦虑、抑郁、压力、生活质量、自我效能、疲劳、疼痛、行为困扰、愤怒和/或学业成绩)。
纳入了 8 项研究,其偏倚风险的证据质量从低到高不等。结果表明,认知行为疗法对焦虑、抑郁、疼痛和行为困扰有良好的效果。荟萃分析还表明,该疗法可降低焦虑(SMD=-0.89,95%CI(-1.45,-0.32),p<0.002)、抑郁(SMD=-0.90,95%CI(-1.40,-0.39),p<0.0005)和疼痛(SMD=-0.56,95%CI(-1.04,-0.08),p<0.002)。虽然这些结果来自于一项研究,但它对压力、愤怒和自我效能也有良好的影响。
认知行为疗法有可能减轻癌症儿童的焦虑、抑郁和疼痛,对行为困扰也有改善作用。虽然已经发现对压力、愤怒和自我效能的影响具有统计学意义,但这些功能方面的研究还很有限,需要开展更多的研究。本研究结果来自异质性参与者和干预措施,因此强调需要开展设计良好的干预研究,包括癌症幸存者。