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心理干预护理对乳腺癌患者生活质量的疗效及安全性的系统评价与Meta分析

Systematic review and meta-analysis of the efficacy and safety of psychological intervention nursing on the quality of life of breast cancer patients.

作者信息

Li Hanbing, Li Junfeng, Wang Xiaoqing, Lin Shuai, Yang Wen, Cai Hui, Feng Xiaofen

机构信息

The Thyroid and Breast Surgery Department, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

Cardiothoracic Surgery, Nanchong City Central Hospital, Nanchong, China.

出版信息

Gland Surg. 2022 May;11(5):882-891. doi: 10.21037/gs-22-206.

Abstract

BACKGROUND

With the increasing incidence of breast cancer, breast cancer patients suffered from psychological problems in different degrees. There was no unified conclusion on whether psychological intervention nursing can improve the quality of life (QOL) of breast cancer patients. This meta-analysis aimed to explore the impact of psychological nursing interventions on the quality of life of breast cancer patients.

METHODS

We retrieved related articles from both English databases (including PubMed, Medline, and Embase) and Chinese databases [including China Biology Medicine DISC (CBMdisc), China National Knowledge Network (CNKI), Wanfang, and China Science and Technology Journal Database (VIP]. All of the databases were searched using a combination of the following search terms: psychological intervention nursing, psychological nursing, psychotherapy, breast loss, radical mastectomy, modified radical mastectomy, and quality of life. The quality of the included literature was assessed using RevMan 5.3 provided by the Cochrane system.

RESULTS

A total of 12 articles were included, and the meta-analysis results showed that the quality of life questionnaire core 30 (QLQ-C 30) was evaluated, and there was heterogeneity among the studies (P<0.00001, I=92%). There was no statistical difference between the intervention group and the control group [standardized mean difference (SMD) =0.58, 95% confidence interval (CI): -0.11-1.27, P=0.10]. Short Form 36 Questionnaire (SF-36) was evaluated, and there was no heterogeneity among the studies (P=0.40, I=0%). The fixed effect model was used for Meta-analysis. There were statistical differences between the intervention group and the control group [mean difference (MD) =6.12, 95% CI: 5.17-7.06, P<0.00001]. According to the evaluation of functional assessment of cancer therapy (FACT), there is heterogeneity among the studies (P=0.003, I=83%). There were statistical differences between the intervention group and the control group (MD =12.74, 95% CI: 6.34-19.14, P<0.0001).

DISCUSSION

Psychological nursing intervention can significantly improve the quality of life of patients with missing breasts undergoing radical mastectomy, which has certain guiding significance for the formulation of clinically effective nursing measures.

摘要

背景

随着乳腺癌发病率的不断上升,乳腺癌患者不同程度地存在心理问题。心理干预护理能否提高乳腺癌患者的生活质量尚无统一结论。本荟萃分析旨在探讨心理护理干预对乳腺癌患者生活质量的影响。

方法

我们从英文数据库(包括PubMed、Medline和Embase)和中文数据库[包括中国生物医学文献数据库(CBMdisc)、中国知网(CNKI)、万方和维普中文科技期刊数据库(VIP)]中检索相关文章。所有数据库均使用以下检索词组合进行检索:心理干预护理、心理护理、心理治疗、乳房缺失、根治性乳房切除术、改良根治性乳房切除术和生活质量。采用Cochrane系统提供的RevMan 5.3对纳入文献的质量进行评估。

结果

共纳入12篇文章,荟萃分析结果显示,对生活质量问卷核心30(QLQ-C 30)进行评估,各研究间存在异质性(P<0.00001,I=92%)。干预组与对照组之间无统计学差异[标准化均数差(SMD)=0.58,95%置信区间(CI):-0.11-1.27,P=0.10]。对简明健康状况调查问卷(SF-36)进行评估,各研究间无异质性(P=0.40,I=0%)。采用固定效应模型进行荟萃分析。干预组与对照组之间存在统计学差异[均数差(MD)=6.12,95%CI:5.17-7.06,P<0.00001]。根据癌症治疗功能评估(FACT)进行评估,各研究间存在异质性(P=0.003,I=83%)。干预组与对照组之间存在统计学差异(MD =12.74,95%CI:6.34-19.14,P<0.0001)。

讨论

心理护理干预能显著提高行根治性乳房切除术的乳房缺失患者的生活质量,对制定临床有效护理措施具有一定的指导意义。

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