Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Cancer Med. 2023 Jun;12(12):13758-13773. doi: 10.1002/cam4.6012. Epub 2023 Apr 29.
We conducted a systematic review and evidence gap mapping to explore the existing supportive care interventions and their impact on well-being outcomes for melanoma patients and caregivers.
We searched MEDLINE, Embase, Web of Science Index Medicus, CINAHL, Lilacs, CENTRAL (Cochrane Library) and PsycINFO in December 2022, including interventional studies assessing the effectiveness of any supportive care intervention among melanoma patients and/or their caregivers.
Twenty studies were included in this review. These studies consisted of randomised controlled trials (n = 11, 55%), pre-post studies (n = 7, 35%) and quasi-experimental trials (n = 2, 10%). All studies originated from high-income countries and focused primarily on melanoma patients, with no studies identified that focused solely on caregivers. Educational interventions were the most common (n = 7, 35%), followed by psychoeducational interventions (n = 6, 30%) and psychotherapeutic interventions (n = 4, 20%). Nearly all included studies (n = 18, 90%) reported a positive effect of the intervention on the primary outcome of interest; however, most studies (n = 17, 85%) were judged to be at moderate or high risk of bias. Due to heterogeneity of study designs, intervention characteristics and outcome measures, meta-analysis was not conducted.
Supportive care interventions have positive impacts on melanoma patient well-being outcomes, while being acceptable and feasible to conduct. More research is needed regarding supportive care interventions for melanoma caregivers. Future research should focus on eliminating sources of bias through rigorous methodology, with the development of standardised outcome measures for psychosocial outcomes to facilitate future meta-analyses.
我们进行了系统评价和证据差距绘图，以探索现有的支持性护理干预措施及其对黑素瘤患者和护理人员的幸福感结局的影响。
我们于 2022 年 12 月检索了 MEDLINE、Embase、Web of Science 索引医学、CINAHL、Lilacs、CENTRAL（Cochrane 图书馆）和 PsycINFO，纳入评估黑素瘤患者和/或其护理人员任何支持性护理干预措施有效性的干预性研究。
本综述纳入了 20 项研究。这些研究包括随机对照试验（n=11，55%）、前后研究（n=7，35%）和准实验试验（n=2，10%）。所有研究均来自高收入国家，主要关注黑素瘤患者，没有专门针对护理人员的研究。教育干预最为常见（n=7，35%），其次是心理教育干预（n=6，30%）和心理治疗干预（n=4，20%）。几乎所有纳入的研究（n=18，90%）都报告了干预对主要结局的积极影响；然而，大多数研究（n=17，85%）被判断为存在中度或高度偏倚风险。由于研究设计、干预措施特征和结局测量的异质性，未进行荟萃分析。
支持性护理干预措施对黑素瘤患者的幸福感结局有积极影响，同时也易于实施和接受。需要更多关于黑素瘤护理人员支持性护理干预的研究。未来的研究应侧重于通过严格的方法消除偏倚源，并制定标准化的心理社会结局测量方法，以促进未来的荟萃分析。
