Marie Curie Palliative Care Research Department, University College London, London, UK.
Primary Care and Population Health, University College London, London, UK.
Palliat Med. 2022 Oct;36(9):1320-1335. doi: 10.1177/02692163221122955. Epub 2022 Sep 7.
Complementary therapies are widely used in palliative care settings. Qualitative research found that people with advanced disease report a range of physical and psychological benefits from complementary therapies, however evidence of their effectiveness from clinical trials is inconclusive. This may be because trials are limited by use of inappropriate outcome measures.
To identify tools which capture the impact of massage, reflexology and aromatherapy in people with advanced disease. We (1) identified multi-domain tools used to evaluate these therapies in populations with any chronic health condition and (2) assessed whether tools were valid and psychometrically robust in populations with advanced disease.
A two-stage systematic review was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines (PROSPERO: CRD42020161199).
Six databases were searched (August 2021). Study methodological quality, tool psychometric properties and evidence quality were assessed. A global comparison score was generated.
Stage 1: 66 trials using 40 different multi-domain tools were identified. Stage 2: Of these tools, we identified papers for seven tools regarding development or validation in advanced disease populations. The majority of psychometric data were inconsistent or inconclusive. Data were mostly of low quality due to methodological issues.
Of the tools identified, 'Functional Assessment of Cancer Therapy - General' appears to be the most suitable alternative tool against COMSIN criteria, for trials of massage, reflexology and aromatherapy in palliative care. Further tool validation is required before firm recommendations can be made. Co-development of a core outcome set could ensure relevant domains are assessed.
补充疗法在姑息治疗环境中被广泛应用。定性研究发现，患有晚期疾病的人报告说从补充疗法中获得了一系列身体和心理上的益处，然而临床试验证明其疗效的证据尚无定论。这可能是因为试验受到了不合适的结果测量方法的限制。
确定能够捕捉按摩、反射疗法和芳香疗法对晚期疾病患者影响的工具。我们（1）确定了用于评估任何慢性健康状况人群中这些疗法的多领域工具，（2）评估了在晚期疾病人群中，这些工具是否具有有效性和心理测量学上的稳健性。
使用共识基础的健康测量工具选择标准（COSMIN）指南（PROSPERO：CRD42020161199）进行了两阶段系统评价。
对六个数据库进行了搜索（2021 年 8 月）。评估了研究方法学质量、工具心理测量学特性和证据质量。生成了一个全球比较评分。
第 1 阶段：确定了 66 项使用 40 种不同多领域工具的试验。第 2 阶段：在这些工具中，我们确定了 7 种工具在晚期疾病人群中进行开发或验证的论文。大多数心理测量学数据不一致或不确定。由于方法学问题，数据大多质量较低。
在所确定的工具中，“癌症治疗功能评估-一般”似乎是根据 COMSIN 标准，最适合用于姑息治疗中按摩、反射疗法和芳香疗法试验的替代工具。在做出明确建议之前，需要进一步验证工具。共同制定核心结局集可以确保评估相关领域。
