School of Nursing, Wuhan University, Wuhan, China.
J Adv Nurs. 2023 Feb;79(2):519-538. doi: 10.1111/jan.15543. Epub 2022 Dec 19.
To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer.
Systematic review and meta-analysis of randomized controlled trials.
Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022.
Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta-analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence.
Eight studies, involving 488 people with advanced cancer, were included. The results showed significant effects of Acceptance and Commitment Therapy on the improvement of quality of life and the alleviation of anxiety, depression, psychological distress and fatigue in people with advanced cancer. However, its effects in relieving psychological flexibility and pain were not statistically significant. The certainty of the evidence was low to moderate.
People with advanced cancer can benefit from Acceptance and Commitment Therapy, which is conducive to improving their health outcomes.
This review provides evidence about the effectiveness of Acceptance and Commitment Therapy in people with advanced cancer. Further well-designed studies with larger sample sizes are required. This review may help nurses and researchers to design and implement Acceptance and Commitment Therapy in clinical practice, thereby improving health outcomes in this population.
CRD42021244568.
系统回顾现有证据,评估接受与承诺疗法在晚期癌症患者中的疗效。
随机对照试验的系统评价和荟萃分析。
检索了 9 个数据库,包括 PubMed、Web of Science、Cochrane 图书馆、Embase、CINAHL、PsycINFO、中国知网、维普数据库和万方,检索时间从选定数据库的创建时间到 2022 年 8 月。
两位作者独立筛选合格研究,并根据 Cochrane 有效实践和组织护理标准评估纳入研究的方法学质量,然后进行数据提取。采用干预描述和复制模板(TIDieR)清单确定干预措施的特征。使用 RevMan 5.4 软件进行荟萃分析,采用推荐评估、制定与评价(GRADE)方法评估证据的确定性。
纳入了 8 项研究,共涉及 488 名晚期癌症患者。结果表明,接受与承诺疗法显著改善了晚期癌症患者的生活质量,缓解了焦虑、抑郁、心理困扰和疲劳,但对心理灵活性和疼痛的缓解效果不具有统计学意义。证据的确定性为低到中度。
接受与承诺疗法对晚期癌症患者有益,有利于改善其健康结局。
本研究为接受与承诺疗法在晚期癌症患者中的有效性提供了证据。需要进一步开展设计良好、样本量更大的研究。本综述可能有助于护士和研究人员在临床实践中设计和实施接受与承诺疗法,从而改善这一人群的健康结局。
PROSPERO 注册号:CRD42021244568。