Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
National University Health System, Singapore.
J Adv Nurs. 2022 Jul;78(7):1883-1896. doi: 10.1111/jan.15258. Epub 2022 Apr 20.
To synthesize the effectiveness of web-based psychosocial interventions on self-efficacy, anxiety, depression, quality of life (QoL), non-specific psychological and cancer-specific distress among patients with colorectal cancer (CRC).
A systematic review and meta-analysis.
Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021.
Experimental/quasi-experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta-analyses and narrative syntheses were performed.
Nineteen studies consisting of 1386 participants were identified. Cognitive-behavioural therapy delivered online was the most common trialled web-based psychosocial intervention. Meta-analyses revealed no positive effect for self-efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p < .01) and minimal benefit for QoL (mean difference [MD] 2.83, 95% CI: -0.31 to 5.98, p = .08) but significant positive effects for anxiety (MD -2.23, 95% CI: -3.31 to -1.14, p < .01) and depression (MD -2.84, 95% CI: -4.09 to -1.59, p < .01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress.
Web-based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self-efficacy and QoL remains inconsistent. More adequately powered, well-designed trials with targeted and theory-based interventions are required to ascertain findings.
By highlighting the potential of web-based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web-based care delivery in light of COVID-19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes. PROSPERO registration number: CRD42021261396.
综合基于网络的心理社会干预对结直肠癌患者自我效能感、焦虑、抑郁、生活质量（QoL）、非特异性心理和癌症特异性困扰的影响。
系统评价和荟萃分析。
从创建到 2021 年 12 月，在 6 个数据库（PubMed、PsycINFO、Embase、Scopus、CINAHL 和 CNKI）中搜索了实验/准实验研究，这些研究涉及改善上述结局的结直肠癌患者。两名审查员筛选和提取数据，并使用偏倚风险工具评估研究的方法学质量。进行了荟萃分析和叙述性综合分析。
确定了 19 项研究，共包括 1386 名参与者。在线提供的认知行为疗法是最常见的试用网络心理社会干预措施。荟萃分析显示，自我效能感没有积极影响（标准化均数差 0.93，95%CI：0.52 至 1.35，p<0.01），生活质量仅有最小益处（平均差[MD]2.83，95%CI：-0.31 至 5.98，p=0.08），但在干预组中，结直肠癌幸存者的焦虑（MD-2.23，95%CI：-3.31 至 -1.14，p<0.01）和抑郁（MD-2.84，95%CI：-4.09 至 -1.59，p<0.01）有显著的积极影响。叙述性综合分析表明，在减轻痛苦方面可能有一定益处。
与传统的交付方式相比，基于网络的心理社会干预是一种很有前途的替代方法，可以降低患者的焦虑、抑郁和困扰。然而，关于自我效能感和生活质量的证据仍然不一致。需要进行更多设计合理、有针对性且基于理论的试验，以确定这些发现。
通过强调基于网络的心理社会干预在降低结直肠癌幸存者焦虑和抑郁方面的潜力，本综述提供了有益的信息，支持在 COVID-19 限制和全国封锁期间使用和接受基于网络的护理服务。同时，实证支持的缺乏反映了需要进行更广泛的研究来测试和改善其他健康结果。PROSPERO 注册号：CRD42021261396。
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