School of Nursing, University of Minnesota, Twin Cities, MN, United States of America.
School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States of America.
PLoS One. 2023 Mar 13;18(3):e0282887. doi: 10.1371/journal.pone.0282887. eCollection 2023.
Lung cancer is one of the common cancers and the leading cause of death. Tremendous caregiving burden of informal caregivers of lung cancer causes psychological disorders, such as anxiety and depression. Interventions for informal caregivers of patients with lung cancer to improve their psychological health, which ultimately leads to patients' positive health outcomes, are crucial. A systematic review and meta-analysis was conducted to: 1) evaluate the effect of non-pharmacological interventions on the outcomes of depression and anxiety for lung cancer patients' informal caregivers; and 2) compare the effects of interventions with differing characteristics (i.e. intervention types, mode of contact, and group versus individual delivery).
Four databases were searched to identify relevant studies. Inclusion criteria for the articles were peer-reviewed non-pharmacological intervention studies on depression and anxiety in lung cancer patients' informal caregivers published between January 2010 and April 2022. Systematic review procedures were followed. Data analysis of related studies was conducted using the Review Manager Version 5.4 software. Intervention effect sizes and studies' heterogeneity were calculated.
Eight studies from our search were eligible for inclusion. Regarding total effect for the caregivers' levels of anxiety and depression, results revealed evidence for significant moderate effects of intervention on anxiety (SMD -0.44; 95% CI, -0.67, -0.21; p = 0.0002) and depression (SMD -0.46; 95% CI, -0.74, -0.18; p = 0.001). Subgroup analyses for both anxiety and depression of informal caregivers revealed moderate to high significant effects for specific intervention types (cognitive behavioral and mindfulness combined with psycho-education interventions), mode of contact (telephone-based interventions), and group versus individual delivery.
This review provides evidence that cognitive behavioral and mindfulness-based, telephone-based, individual or group-based interventions were effective for informal caregivers of lung cancer patients. Further research is needed to develop the most effective intervention contents and delivery methods across informal caregivers with larger sample size in randomized controlled trials.
肺癌是常见癌症之一，也是主要的死亡原因。肺癌患者非专业照护者的巨大照护负担会导致焦虑和抑郁等心理障碍。对肺癌患者非专业照护者进行干预，以改善其心理健康，从而最终改善患者的健康结局，这一点至关重要。本系统评价和荟萃分析旨在：1）评估非药物干预对肺癌患者非专业照护者的抑郁和焦虑结局的影响；2）比较具有不同特征（即干预类型、联系方式和小组或个体提供）的干预措施的效果。
检索了四个数据库以确定相关研究。纳入的文章标准为 2010 年 1 月至 2022 年 4 月发表的关于肺癌患者非专业照护者抑郁和焦虑的同行评议非药物干预研究。遵循系统评价程序。使用 Review Manager Version 5.4 软件对相关研究进行数据分析。计算干预效果大小和研究的异质性。
从我们的检索中，有八项研究符合纳入标准。关于照护者焦虑和抑郁水平的总效应，结果显示干预对焦虑（SMD-0.44；95%CI，-0.67，-0.21；p=0.0002）和抑郁（SMD-0.46；95%CI，-0.74，-0.18；p=0.001）具有显著的中度效应。对非专业照护者焦虑和抑郁的亚组分析显示，特定干预类型（认知行为和正念结合心理教育干预）、联系方式（基于电话的干预）和小组与个体提供方式具有中度到高度显著效果。
本综述提供的证据表明，认知行为和正念为基础、基于电话的、个体或小组为基础的干预措施对肺癌患者的非专业照护者是有效的。需要进一步的研究，以便在更大规模的随机对照试验中为具有不同特征的非专业照护者制定最有效的干预内容和提供方法。
