意义疗法对癌症患者精神性、心理健康及生活质量的影响：一项随机对照试验的系统评价与荟萃分析

Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials.

作者信息

Sun Mimi, Tian Xia, Peng Yunyi, Wang Zheng, Lu Yongmei, Xiao Wenli

机构信息

School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

出版信息

Asia Pac J Oncol Nurs. 2024 Feb 2;11(4):100388. doi: 10.1016/j.apjon.2024.100388. eCollection 2024 Apr.

DOI:10.1016/j.apjon.2024.100388

PMID:38586470

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10997828/

Abstract

OBJECTIVE

This study aimed to systematically review studies of meaning therapy on patients with cancer and to evaluate its effectiveness on spiritual outcomes, psychological outcomes, and quality of life (QOL).

METHODS

A comprehensive literature search were performed in five international databases (PubMed, Embase, Web of Science, The Cochrane Library, and CINAHL) and four Chinese databases (CNKI, Wanfang Data, VIP, and CBM) from the inception to August 2023. The methodological quality of each included studies was evaluated by using the revised Cochrane risk-of-bias tool for randomized trials. The random-effects model or fixed-effects model was utilized for effect size analysis, and the standardized mean difference (SMD) or mean difference (MD) along with its corresponding 95% confidence interval (CI) was computed. Meta-analysis was conducted by using the RevMan software 5.4.1.

RESULTS

Eight randomized controlled trials with 1251 participants were included in this review. Meta-analyses revealed that meaning therapy can significantly improve the spiritual outcomes including meaning in life (SMD = -0.48; 95% CI = -0.89 to -0.07; = 0.02), hopelessness (SMD = -0.30; 95% CI = -0.51 to -0.09; = 0.005), self-esteem (MD = -2.74; 95% CI = -4.17 to -1.32; = 0.0002) and spiritual well-being (MD = -3.32; 95% CI = -5.63 to -1.01; = 0.005), psychological outcomes including anxiety (MD = -0.66; 95% CI = -1.30 to -0.01; = 0.05), depression (SMD = -0.37; 95% CI = -0.55 to -0.20; < 0.0001), psychological distress (SMD = -0.35; 95% CI = -0.70 to -0.01; = 0.04) and desire for hastened death (MD = -0.76; 95% CI = -1.47 to -0.05; = 0.04), and QOL (SMD = -0.29; 95% CI = -0.50 to -0.09; = 0.006) in patients with cancer.

CONCLUSIONS

Meaning therapy has positive effects on improving spirituality, psychological health, and QOL of patients with cancer. More high-quality randomized controlled trials with larger sample sizes are warranted to confirm the results of our review and to clarify the long-term effects of meaning therapy in the future.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO (No. CRD42021278286).

摘要

目的

本研究旨在系统回顾针对癌症患者的意义疗法研究，并评估其对精神结局、心理结局和生活质量（QOL）的有效性。

方法

从建库至2023年8月，在五个国际数据库（PubMed、Embase、Web of Science、Cochrane图书馆和CINAHL）和四个中文数据库（中国知网、万方数据、维普和中国生物医学文献数据库）中进行了全面的文献检索。使用修订后的Cochrane随机试验偏倚风险工具评估每项纳入研究的方法学质量。采用随机效应模型或固定效应模型进行效应量分析，并计算标准化均数差（SMD）或均数差（MD）及其相应的95%置信区间（CI）。使用RevMan软件5.4.1进行荟萃分析。

结果

本综述纳入了八项随机对照试验，共1251名参与者。荟萃分析显示，意义疗法可显著改善精神结局，包括生命意义（SMD = -0.48；95% CI = -0.89至-0.07；P = 0.02）、绝望感（SMD = -0.30；95% CI = -0.51至-0.09；P = 0.005）、自尊（MD = -2.74；95% CI = -4.17至-1.32；P = 0.0002）和精神幸福感（MD = -3.32；95% CI = -5.63至-1.01；P = 0.005）；心理结局，包括焦虑（MD = -0.66；95% CI = -1.30至-0.01；P = 0.05）、抑郁（SMD = -0.37；95% CI = -0.55至-0.20；P < 0.0001）、心理困扰（SMD = -0.35；95% CI = -0.70至-0.01；P = 0.04）和加速死亡愿望（MD = -0.76；95% CI = -1.47至-0.05；P = 0.04）；以及癌症患者的生活质量（SMD = -0.29；95% CI = -0.50至-0.09；P = 0.006）。