系统评价应对技能干预对减轻血液恶性肿瘤成人焦虑和抑郁症状的效果。
A systematic review of coping skill interventions to reduce anxiety and depressive symptoms among adults with hematologic malignancies.
机构信息
University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA.
University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA.
出版信息
Eur J Oncol Nurs. 2022 Dec;61:102224. doi: 10.1016/j.ejon.2022.102224. Epub 2022 Oct 31.
BACKGROUND
Patients with hematologic malignancies experience anxiety and depressive symptoms from diagnosis through survivorship. The aim of this systematic review is to determine if coping skill interventions can reduce anxiety and depressive symptoms for persons with hematologic cancer.
METHODS
Databases including PubMed, Embase, CINAHL, APA PyschInfo, Scopus, and Cochrane were searched in June of 2021 for coping skill interventional studies with adult patients with hematologic cancer and outcomes of anxiety and depressive symptoms. Search terms, definitions, and inclusion/exclusion criteria were guided by the Transactional Model of Stress and Coping, and quality appraisal utilized the Johns Hopkins Evidence Based Practice Appraisal tool. The study was registered in PROSPERO under "CRD42021262967."
RESULTS
Eleven studies met inclusion criteria with ten studies evaluating anxiety symptoms and nine studies evaluating depressive symptoms. Of ten studies with 449 participants evaluating anxiety, five studies showed significant reduction (p < 0.05), three found small to moderate effect size reductions not reaching statistical significance (p > 0.05), and only two showed no reduction in anxiety symptoms. Of nine studies with 429 participants evaluating depressive symptoms, three had significant reductions (p < 0.05), three reported small to moderate effect size reductions not reaching statistical significance (p > 0.05), and three found no effect on depressive symptoms. Coping interventions that were problem-focused as opposed to emotion-focused were most effective for both anxiety and depressive symptoms.
CONCLUSION
This systematic review finds evidence that problem-focused coping interventions reduce anxiety symptoms among patients with hematologic malignancies, with mixed evidence for reduction of depressive symptoms. Nurses and other clinicians caring for patients with hematologic cancers may employ coping skill interventions as a potential way to mitigate anxiety and depressive symptoms.
PROSPERO REGISTRATION ID
CRD42021262967.
背景
从诊断到生存，血液系统恶性肿瘤患者会经历焦虑和抑郁症状。本系统评价的目的是确定应对技能干预是否可以减轻血液系统癌症患者的焦虑和抑郁症状。
方法
2021 年 6 月，我们在 PubMed、Embase、CINAHL、APA PyschInfo、Scopus 和 Cochrane 数据库中搜索了针对血液系统恶性肿瘤成年患者的应对技能干预研究，并检索了焦虑和抑郁症状的结果。搜索词、定义和纳入/排除标准由应激和应对的交易模型指导，质量评估采用约翰霍普金斯循证实践评估工具。该研究在 PROSPERO 中以“CRD42021262967”注册。
结果
11 项研究符合纳入标准，其中 10 项研究评估了焦虑症状，9 项研究评估了抑郁症状。在评估焦虑的 10 项研究中，有 449 名参与者，其中 5 项研究显示焦虑症状显著减轻（p<0.05），3 项研究发现小到中度的效应量减少但未达到统计学意义（p>0.05），只有 2 项研究未减轻焦虑症状。在评估抑郁症状的 9 项研究中，有 429 名参与者，其中 3 项研究显示抑郁症状显著减轻（p<0.05），3 项研究报告小到中度的效应量减少但未达到统计学意义（p>0.05），3 项研究未发现抑郁症状的影响。与情绪焦点相比，问题焦点的应对干预措施对焦虑和抑郁症状最有效。
结论
本系统评价发现，问题焦点应对干预措施可减轻血液系统恶性肿瘤患者的焦虑症状，减轻抑郁症状的证据不一。护理血液系统癌症患者的护士和其他临床医生可能会采用应对技能干预措施作为减轻焦虑和抑郁症状的潜在方法。
PROSPERO 注册号：CRD42021262967。
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