College of Medicine, Central Michigan University, Mt Pleasant, MI 48859, USA.
School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
Int J Environ Res Public Health. 2024 Jul 6;21(7):881. doi: 10.3390/ijerph21070881.
Cognitive behavioral therapy (CBT) has been successfully utilized in improving mental health (MH) and quality of life (QoL) in the general population, regardless of age. Cancer, which is most frequently diagnosed in older adults, is a debilitating illness that has a detrimental and long-lasting effect on patients' MH and QoL. While numerous studies have demonstrated CBT's efficacy, little evidence exists for its role in older cancer patients. This study, using MH and QoL metrics, evaluates the effectiveness of CBT for older adult cancer patients.
Focusing on MH and QoL and an average age of over 60 years old, a final analysis was performed on 17 clinical trials with a total of 124 effect sizes, including 3073 participants receiving CBT. "Metaphor" and "Robumeta" packages in R Statistical Software (version 4.2.2) were used for analysis, which included robust variance estimation (RVE) in intercept-only meta-regression, and univariate meta-regression for moderator analysis.
With 17 clinical trials and 124 effect sizes, our results show that CBT moderately improves MH and QoL in cancer patients d = 0.19, 95% CI 0.0166-0.364, < 0.0399. The delivery format was shown to be a strong moderator of CBT effectiveness with interpersonal technological interventions combined with pre-programmed segments having a very strong treatment effect size (d = 1.7307, 95% CI 1.5244-1.937, < 0.001).
The use of CBT in older adult cancer patients statistically improves MH and QoL, with delivery format and stages of treatment having important roles. Tech-only interpersonal interventions combined with pre-programmed CBT provide an avenue for targeting older adult cancer patients.
认知行为疗法（CBT）已成功应用于改善一般人群的心理健康（MH）和生活质量（QoL），无论年龄大小。癌症是最常见于老年人的疾病，它对患者的 MH 和 QoL 产生有害且持久的影响。尽管有许多研究证明了 CBT 的疗效，但关于其在老年癌症患者中的作用的证据很少。本研究使用 MH 和 QoL 指标评估 CBT 对老年癌症患者的有效性。
本研究重点关注 MH 和 QoL 以及平均年龄在 60 岁以上，对 17 项临床试验进行了最终分析，共包括 124 个效应量，其中 3073 名参与者接受了 CBT。使用 R 统计软件（版本 4.2.2）中的“Metaphor”和“Robumeta”包进行分析，包括仅截距元回归中的稳健方差估计（RVE）和调节分析的单变量元回归。
通过 17 项临床试验和 124 个效应量，我们的结果表明 CBT 适度改善了癌症患者的 MH 和 QoL（d = 0.19，95%CI 0.0166-0.364， < 0.0399）。研究结果表明，CBT 的实施方式是影响其效果的重要因素，人际技术干预与预编程片段相结合具有很强的治疗效果（d = 1.7307，95%CI 1.5244-1.937， < 0.001）。
CBT 用于老年癌症患者可在统计学上改善 MH 和 QoL，并且实施方式和治疗阶段起着重要作用。仅人际技术干预与预编程 CBT 相结合为针对老年癌症患者提供了一种途径。
