Phiri Lophina, Li William Ho Cheung, Cheung Ankie Tan, Phiri Patrick G M C
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Institute of Applied Technology, Fatima College of Health Sciences, Al Ain, United Arab Emirates.
Psychooncology. 2023 Oct;32(10):1514-1527. doi: 10.1002/pon.6208. Epub 2023 Aug 28.
Psychoeducation interventions (PEIs) have been used as an adjunct treatment for negative psychological outcomes in caregivers of children with cancer. This systematic review and meta-analysis aimed to evaluate the evidence on the effectiveness of PEIs in reducing anxiety and depressive symptoms and improving health-related quality of life (HRQoL) and coping skills in caregivers of children with cancer.
Ten English databases were searched to identify studies on PEIs for caregivers of children with cancer. Studies inclusion criteria were as follows: (1) participants who were caregivers of children with cancer receiving treatment; (2) psychoeducational interventions assessing anxiety, depressive symptoms, HRQoL, and coping outcomes; and (3) usual care, waitlist, or active control as a control group. Meta-analysis and narrative synthesis were used to analyse data.
Fourteen randomised control trials were included. PEIs have a beneficial effect on anxiety levels (SMD: -0.59, 95% CI [-0.92, -0.25], p = 0.0007), quality of life (SMD: -0.31, 95% CI [-0.00, -0.61], p = 0.05) and depressive symptoms (SMD: -1.18, 95% CI [-2.08, -0.28], p = 0.01) immediately post-intervention. The effect of PEIs was maintained at long-term follow-up on depressive symptoms (SMD: -0.52, 95% CI [-1.54, -0.36], p = 0.0004). Similarly, the synthesised data suggest that PEIs are effective in improving coping skills.
The review provides evidence that PEIs effectively reduce negative psychological outcomes and improve coping skills in caregivers of children with cancer. However, due to methodological flaws and heterogeneity of the interventions evaluated, more research is needed to determine the most effective PEI design and improve the quality of evidence.
心理教育干预（PEIs）已被用作癌症患儿照料者负面心理结果的辅助治疗。本系统评价和荟萃分析旨在评估PEIs在减轻焦虑和抑郁症状、改善癌症患儿照料者的健康相关生活质量（HRQoL）和应对技能方面有效性的证据。
检索了10个英文数据库，以确定关于癌症患儿照料者PEIs的研究。研究纳入标准如下：（1）为接受治疗的癌症患儿的照料者的参与者；（2）评估焦虑、抑郁症状、HRQoL和应对结果的心理教育干预；（3）作为对照组的常规护理、候补名单或积极对照。采用荟萃分析和叙述性综合分析数据。
纳入了14项随机对照试验。PEIs在干预后即刻对焦虑水平（标准化均数差：-0.59，95%可信区间[-0.92，-0.25]，p = 0.0007）、生活质量（标准化均数差：-0.31，95%可信区间[-0.00，-0.61]，p = 0.05）和抑郁症状（标准化均数差：-1.18，95%可信区间[-2.08，-0.28]，p = 0.01）有有益影响。PEIs的效果在抑郁症状的长期随访中得以维持（标准化均数差：-0.52，95%可信区间[-1.54，-0.36]，p = 0.0004）。同样，综合数据表明PEIs在改善应对技能方面是有效的。
该评价提供了证据表明PEIs能有效减轻癌症患儿照料者的负面心理结果并改善应对技能。然而由于所评估干预措施的方法学缺陷和异质性，需要更多研究来确定最有效的PEI设计并提高证据质量。
