School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR.
School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR.
J Pain Symptom Manage. 2024 Jul;68(1):e8-e20. doi: 10.1016/j.jpainsymman.2024.03.015. Epub 2024 Mar 20.
Although spiritual intervention is crucial in the care of childhood cancer patients (CCPs), its effectiveness has not yet been systematically evaluated.
To determine the effectiveness of existing spiritual interventions on psychological, spiritual outcomes, and quality of life (QoL) in CCPs.
We searched eight databases to identify relevant randomized controlled trials and quasi-experimental studies. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Results were either synthesized in a systematic narrative synthesis or a meta-analysis using a random effects model, where appropriate. The pooled treatment effect was estimated using the standardized mean difference (SMD) and 95% confidence interval (CI).
Twelve studies with 576 CCPs were included. Eight studies showed a high risk of bias. The overall effect of existing spiritual interventions on QoL (Z = 1.05, SMD = 0.64, 95%CI = -0.15 to 1.83, P = 0.29), anxiety (Z = 1.11, SMD = -0.83, 95%CI = -2.30 to 0.64, P = 0.28) and depressive symptoms (Z = 1.06, SMD = -0.49, 95%CI = -1.40 to 0.42, P = 0.12) were statistically nonsignificant. The nonsignificant findings could be attributed to the high heterogeneity among the included studies (QoL: I = 85%; anxiety: I = 90%; depressive symptoms: I = 58%).
Evidence to support the positive effects of existing spiritual interventions on psychological and spiritual outcomes and QoL in CCPs is insufficient. Future studies should adopt a more rigorous design and unify the outcome measures to reduce the risk of bias and heterogeneity, respectively.
尽管精神干预在儿童癌症患者（CCP）的护理中至关重要，但它的有效性尚未得到系统评估。
确定现有的精神干预措施对 CCP 心理、精神结局和生活质量（QoL）的影响。
我们检索了八个数据库，以确定相关的随机对照试验和准实验研究。使用 Cochrane 随机对照试验偏倚风险工具评估偏倚风险。结果以系统叙述性综述或适当情况下的荟萃分析进行综合。使用标准化均数差（SMD）和 95%置信区间（CI）估计汇总治疗效果。
纳入了 12 项研究，共 576 例 CCP。其中 8 项研究存在高偏倚风险。现有精神干预对 QoL 的总体影响（Z = 1.05，SMD = 0.64，95%CI = -0.15 至 1.83，P = 0.29）、焦虑（Z = 1.11，SMD = -0.83，95%CI = -2.30 至 0.64，P = 0.28）和抑郁症状（Z = 1.06，SMD = -0.49，95%CI = -1.40 至 0.42，P = 0.12）均无统计学意义。这些无统计学意义的结果可能归因于纳入研究之间的高度异质性（QoL：I = 85%；焦虑：I = 90%；抑郁症状：I = 58%）。
现有精神干预对 CCP 心理、精神结局和生活质量的积极影响证据不足。未来的研究应采用更严格的设计并统一结局测量，以分别降低偏倚和异质性的风险。
