Yu Shuanghan, Liu Yantong, Cao Minglu, Tian Qi, Xu Mengmeng, Yu Lin, Yang Shu, Zhang Wei
Author Affiliations: School of Nursing, Jilin University, Changchun, Jilin Province, China.
Cancer Nurs. 2025;48(3):e140-e149. doi: 10.1097/NCC.0000000000001274. Epub 2023 Aug 8.
Internet-based cognitive behavioral therapy (ICBT) is a relatively new therapy with unknown effectiveness in patients with cancer. In addition, therapist-guided and self-guided ICBT patient-specific outcomes for cancer patients remain to be explored.
To explore the effects of ICBT on psychological outcomes, physical outcomes, and daily life outcomes in patients with cancer.
Electronic databases such as PubMed, Web of Science, Cochrane Library, EMBASE, APA PsycINFO, ProQuest, and ClinicalTrials.gov were searched for relevant studies published from their inception to October 2022. Five GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) considerations were used to assess the quality of relevant evidence. Data analysis was performed via RevMan 5.4 (The Cochrane Collaboration, London, United Kingdom) and Stata 15.0 (StataCorp, College Station, Texas).
Three thousand two hundred forty-nine participants from 20 studies were included in the meta-analysis. Statistically significant effects of ICBT were found on psychological distress, quality of life (QOL), anxiety, and depression, after the intervention. A separate analysis of follow-up data showed that ICBT had a sustainable effect on psychological distress, anxiety, and depression. Subgroup analyses showed that therapist-guided ICBT was more effective for psychological distress and QOL.
Internet-based cognitive behavioral therapy can improve symptom management for patients with cancer.
Internet-based cognitive behavioral therapy effectively improves psychological distress, anxiety, and depression in patients with cancer after intervention and at follow-up. Internet-based cognitive behavioral therapy improved QOL for cancer patients postintervention but not during follow-up. Internet-based cognitive behavioral therapy did not relieve fatigue or fear of recurrence in cancer patients. Therapist-guided ICBT is recommended for its superior outcomes in alleviating psychological distress and improving overall QOL in adults with cancer when compared with self-guided ICBT.
基于互联网的认知行为疗法（ICBT）是一种相对较新的疗法，其对癌症患者的有效性尚不清楚。此外，针对癌症患者，由治疗师指导和自我指导的ICBT特定患者结局仍有待探索。
探讨ICBT对癌症患者心理结局、身体结局和日常生活结局的影响。
检索了电子数据库，如PubMed、科学网、考克兰图书馆、EMBASE、美国心理学会心理学文摘数据库、ProQuest和ClinicalTrials.gov，以查找从创建至2022年10月发表的相关研究。使用五项GRADE（推荐分级、评估、制定和评价）考量来评估相关证据的质量。通过RevMan 5.4（英国伦敦考克兰协作组织）和Stata 15.0（美国德克萨斯州大学站市StataCorp公司）进行数据分析。
20项研究中的3249名参与者被纳入荟萃分析。干预后发现ICBT对心理困扰、生活质量（QOL）、焦虑和抑郁有统计学上的显著影响。对随访数据的单独分析表明，ICBT对心理困扰、焦虑和抑郁有持续影响。亚组分析表明，由治疗师指导的ICBT对心理困扰和QOL更有效。
基于互联网的认知行为疗法可改善癌症患者的症状管理。
基于互联网的认知行为疗法在干预后及随访时能有效改善癌症患者的心理困扰、焦虑和抑郁。基于互联网的认知行为疗法在干预后改善了癌症患者的QOL，但在随访期间未改善。基于互联网的认知行为疗法未缓解癌症患者的疲劳或对复发的恐惧。与自我指导的ICBT相比，推荐由治疗师指导的ICBT，因其在缓解成年癌症患者心理困扰和改善总体QOL方面有更优结局。
