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远程医疗干预对癌症患者焦虑和抑郁的影响:随机对照试验的系统评价和荟萃分析。

Effect of telehealth interventions on anxiety and depression in cancer patients: A systematic review and meta-analysis of randomized controlled trials.

机构信息

The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

J Telemed Telecare. 2024 Aug;30(7):1053-1064. doi: 10.1177/1357633X221122727. Epub 2022 Sep 4.

DOI:10.1177/1357633X221122727
PMID:36062618
Abstract

INTRODUCTION

Cancer patients not only experience a variety of problems associated with the treatment of their disease but also a range of psychological problems such as anxiety and depression, which may lead to reduced adherence to treatment and a lower quality of life for cancer patients. Telehealth interventions are widely used for cancer patients, and their effectiveness in improving anxiety and depression in cancer patients is variable and still contradictory.

METHODS

Embase, Pubmed, Web of Science, PsycINFO, CINAHL Complete, and the Cochrane Central Register of Controlled Trials were searched from inception to 19 April 2022. Data synthesis was conducted using STATA 15.0, and scores for anxiety and depression were calculated using standardized mean differences and 95% confidence intervals.

RESULTS

A total of 13125 cancer patients from 68 randomized controlled trials were included in the systematic evaluation. The meta-analysis showed that the telehealth intervention had a significant effect on anxiety (standardized mean differences = -0.40, 95% confidence intervals: -0.6 to 0.2,  < 0.001) and depression (standardized mean differences = -0.48, 95% confidence intervals: -0.67 to 0.28,  < 0.001) in patients with cancer.

DISCUSSION

Telehealth interventions significantly improved anxiety and depression levels in cancer patients compared to traditional care interventions. Breast cancer patients most often received telehealth interventions; electronic device-based and application-based telehealth interventions were more effective than online interventions; short-term interventions were more effective than medium-term and long-term interventions, and different outcome measurement tools led to different intervention outcomes. More high-quality research is needed to explore the effects of telehealth interventions.

摘要

简介

癌症患者不仅会经历与疾病治疗相关的各种问题,还会出现焦虑和抑郁等一系列心理问题,这可能导致治疗依从性降低,癌症患者的生活质量下降。远程医疗干预措施广泛用于癌症患者,其改善癌症患者焦虑和抑郁的效果存在差异,仍存在争议。

方法

从建库到 2022 年 4 月 19 日,我们检索了 Embase、Pubmed、Web of Science、PsycINFO、CINAHL Complete 和 Cochrane 中央对照试验注册库。使用 STATA 15.0 进行数据合成,使用标准化均数差和 95%置信区间计算焦虑和抑郁评分。

结果

共有 68 项随机对照试验的 13125 例癌症患者纳入系统评价。荟萃分析显示,远程医疗干预对癌症患者的焦虑(标准化均数差 = -0.40,95%置信区间:-0.6 至 0.2, < 0.001)和抑郁(标准化均数差 = -0.48,95%置信区间:-0.67 至 0.28, < 0.001)均有显著影响。

讨论

与传统护理干预相比,远程医疗干预可显著改善癌症患者的焦虑和抑郁水平。乳腺癌患者最常接受远程医疗干预;基于电子设备和应用程序的远程医疗干预比在线干预更有效;短期干预比中期和长期干预更有效,不同的结局测量工具导致不同的干预结果。需要更多高质量的研究来探索远程医疗干预的效果。

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