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与间皮瘤共存:对患者及其非正式照护者的心理健康和福祉影响及干预措施的系统评价。

Living with mesothelioma: a systematic review of mental health and well-being impacts and interventions for patients and their informal carers.

机构信息

Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK

Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.

出版信息

BMJ Open. 2024 Jul 1;14(6):e075071. doi: 10.1136/bmjopen-2023-075071.

Abstract

OBJECTIVES

Mesothelioma is an aggressive cancer predominantly affecting the lung and abdominal linings. It can have a unique impact on mental health and well-being (MHWB) due to its incurability, poor prognosis and asbestos-exposure causation. This review's aims were to identify/synthesise international evidence on mesothelioma's MHWB impacts; explore MHWB interventions used by patients and carers; and identify evidence of their effectiveness.

DESIGN

Systematic review.

DATA SOURCES

Databases, searched March 2022 and March 2024, were MEDLINE; CINAHL; PsycINFO; Cochrane Library; ASSIA.

ELIGIBILITY CRITERIA

We included study designs focusing on psychological impacts of living with mesothelioma and MHWB interventions used by patients and informal carers, published in English since January 2002.

DATA EXTRACTION AND SYNTHESIS

A team of reviewers screened included studies using standardised methods. Quality was assessed using validated tools: Mixed-Methods Appraisal tool for primary research and Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews.

RESULTS

Forty-eight studies met the inclusion criteria: 20 qualitative, 16 quantitative, nine reviews, two mixed-methods, one combined systematic review/qualitative study. UK studies predominated. Many MHWB impacts were reported, including traumatic stress, depression, anxiety and guilt. These were influenced by mesothelioma's causation, communication issues and carer-patient relational interactions. Participants used wide-ranging MHWB interventions, including religious/spiritual practice; talking to mental-health professionals; meaning-making. Some strategies were presented as unhelpful, for example, denial. Participants reported lack of access to support.

CONCLUSIONS

Most qualitative studies were rated high quality. The quality of the quantitative studies and reviews varied. The sparse literature regarding MHWB in mesothelioma means more research is needed into impacts on patients and carers, including trauma. To enable access to evidence-based support, research is recommended concerning MHWB interventions' effectiveness in mesothelioma.

PROSPERO REGISTRATION NUMBER

CRD42022302187.

摘要

目的

间皮瘤是一种主要影响肺部和腹部衬里的侵袭性癌症。由于其不可治愈性、预后不良和石棉暴露引起,它可能对心理健康和幸福感(MHWB)产生独特的影响。本综述的目的是确定/综合国际间皮瘤对 MHWB 影响的证据;探索患者和护理人员使用的 MHWB 干预措施;并确定其有效性的证据。

设计

系统评价。

数据来源

2022 年 3 月和 2024 年 3 月,我们在 MEDLINE、CINAHL、PsycINFO、Cochrane 图书馆、ASSIA 等数据库中进行了搜索。

入选标准

我们纳入了关注间皮瘤患者生活中的心理影响以及患者和非专业护理人员使用的 MHWB 干预措施的研究设计,这些研究自 2002 年 1 月以来以英文发表。

数据提取和综合

一个评审团队使用标准方法筛选纳入的研究。使用经过验证的工具评估质量:初级研究的混合方法评估工具和系统评价的 Joanna Briggs 研究所批判性评估清单。

结果

有 48 项研究符合纳入标准:20 项定性研究、16 项定量研究、9 项综述、2 项混合方法研究、1 项结合系统评价/定性研究。英国的研究居多。报告了许多 MHWB 影响,包括创伤后应激、抑郁、焦虑和内疚。这些受到间皮瘤病因、沟通问题和护理人员-患者关系互动的影响。参与者使用了广泛的 MHWB 干预措施,包括宗教/精神实践、与心理健康专业人员交谈、寻找意义。一些策略被认为没有帮助,例如否认。参与者报告缺乏支持。

结论

大多数定性研究的质量评分较高。定量研究和综述的质量参差不齐。间皮瘤中 MHWB 的文献稀少意味着需要对患者和护理人员的影响进行更多研究,包括创伤。为了能够获得基于证据的支持,建议研究间皮瘤中 MHWB 干预措施的有效性。

PROSPERO 注册号:CRD42022302187。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c41c/11218022/2ef29e4d238e/bmjopen-2023-075071f01.jpg

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