Dublin City University, Dublin, Ireland.
Royal College of Surgeons, Dublin, Ireland.
Psychooncology. 2022 Dec;31(12):2050-2062. doi: 10.1002/pon.6029. Epub 2022 Oct 4.
Cancer remains one of the most enduring health crises of the modern world. Prehabilitation is a relatively new intervention aimed at preparing individuals for the stresses associated with treatment from diagnosis. Prehabilitation can include exercise, psychological and nutrition-based interventions. The present systematic review aimed to assess the efficacy of prehabilitation on affective and functional outcomes for young to midlife adult cancer patients (18-55 years). Outcomes of interest included prehabilitation programme composition, duration, mode of delivery and measures used to determine impact on affective and functional outcomes.
The following databases were searched with controlled and free text vocabulary; Psychological Information database (PsychINFO), Culmunated Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE) and Public MEDLINE (PubMed). Abstract and full-text screening was conducted with a secondary reviewer and final texts were subject to risk of bias analysis.
Thirteen texts were included at full-text. These included data of 797 prehabilitation participants (mean age 53 years) and a large representation of female participants (71% average). Evidence was found for the efficacy of psychological prehabilitation for anxiety reduction. Prehabilitation did not significantly affect health related quality of life. Findings moderately supported the therapeutic validity of exercise prehabilitation for functional outcomes, both in terms of clinical and experimental improvement with respect to the quality of evidence. Variation between all prehabilitation types was observed. There was insufficient evidence to support the efficacy of psychological prehabilitation on stress, distress or depression.
Implications for future research are highlighted and then discussed with respect to this young to midlife age group.
癌症仍然是现代世界最持久的健康危机之一。预康复是一种相对较新的干预措施，旨在使个体为从诊断到治疗的各种压力做好准备。预康复可以包括运动、心理和营养干预。本系统评价旨在评估预康复对年轻到中年成年癌症患者（18-55 岁）的情感和功能结局的疗效。感兴趣的结果包括预康复计划的组成、持续时间、交付模式以及用于确定对情感和功能结局影响的措施。
使用受控和自由文本词汇搜索以下数据库：心理信息数据库（PsychINFO）、综合护理与联合健康文献索引（CINAHL）、医学文献分析与检索系统在线（MEDLINE）、医学文摘数据库（EMBASE）和公共 MEDLINE（PubMed）。由二级审稿人进行摘要和全文筛选，最终文本进行偏倚风险分析。
13 篇全文纳入研究。这些研究包括 797 名预康复参与者的数据（平均年龄 53 岁），其中女性参与者的代表性较大（平均 71%）。有证据表明，心理预康复可有效降低焦虑。预康复对健康相关生活质量没有显著影响。研究结果中等程度支持运动预康复对功能结局的治疗有效性，无论从临床改善还是实验改善的角度来看，证据质量都较高。观察到所有预康复类型之间存在差异。没有足够的证据支持心理预康复对压力、痛苦或抑郁的疗效。
强调了对未来研究的影响，并针对该年轻到中年年龄组进行了讨论。
