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基于虚拟现实的癌症患者支持性护理干预措施:系统评价和荟萃分析的伞式综述。

Virtual reality-based supportive care interventions for patients with cancer: an umbrella review of systematic reviews and meta-analyses.

机构信息

Department of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, CO, USA.

Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

Support Care Cancer. 2024 Aug 21;32(9):603. doi: 10.1007/s00520-024-08813-8.

Abstract

PURPOSE

This umbrella review aimed to identify, critically appraise, and synthesize current evidence from systematic reviews and meta-analyses on the applications of virtual reality-based supportive care interventions in cancer.

METHODS

Three bibliographic databases were searched from inception to February 1, 2024. Two independent reviewers screened the titles and abstracts of 421 records and retrieved 26 full-text systematic reviews. Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) was used for quality assessment. Qualitative syntheses were performed to investigate the effects of virtual reality-based supportive care interventions on quality of life and physical, psychological, cognitive, and functional outcomes. Meta-analysis was performed based on data from the distinct primary studies that were extracted from the included reviews.

RESULTS

This umbrella review included 20 systematic reviews that were published between 2018 and 2023; nine of them conducted meta-analyses. A total of 86 distinct primary studies were identified. According to the AMSTAR-2 assessment, two reviews were evaluated as moderate quality, nine as low, and nine as critically low. Meta-analyses of primary studies revealed significant effects of virtual reality on anxiety (p < 0.001), depression (p < 0.001), and pain (p < 0.001), but not fatigue (p = 0.263). Qualitative syntheses revealed positive effects of virtual reality on physical function, cognitive function, and quality of life. Limited evidence was reported regarding outcomes of balance, gait, mobility, and activities of daily living.

CONCLUSION

Virtual reality has proven to be a safe and feasible approach to deliver supportive care in cancer. Virtual reality can be implemented in various stages and settings of the cancer care continuum to support patients undergoing painful procedures, during or after chemotherapy, and after surgical interventions. Virtual reality can serve as an effective supportive care intervention to manage anxiety, pain, and depression for patients with cancer.

摘要

目的

本伞式综述旨在识别、批判性评价和综合目前来自系统评价和荟萃分析的关于虚拟现实支持性护理干预在癌症中的应用的证据。

方法

从建库开始至 2024 年 2 月 1 日,我们检索了三个文献数据库。两位独立的审查员筛选了 421 条记录的标题和摘要,并检索了 26 篇全文系统评价。使用 AMSTAR-2 评估系统评价的方法学质量。进行定性综合分析以调查基于虚拟现实的支持性护理干预对生活质量以及身体、心理、认知和功能结果的影响。根据从纳入的综述中提取的不同原始研究的数据进行荟萃分析。

结果

本伞式综述纳入了 20 篇发表于 2018 年至 2023 年的系统评价,其中 9 篇进行了荟萃分析。共确定了 86 项不同的原始研究。根据 AMSTAR-2 评估,有 2 篇评价为中度质量,9 篇为低质量,9 篇为极低质量。对原始研究的荟萃分析显示,虚拟现实对焦虑(p<0.001)、抑郁(p<0.001)和疼痛(p<0.001)有显著影响,但对疲劳(p=0.263)没有影响。定性综合分析显示,虚拟现实对身体功能、认知功能和生活质量有积极影响。关于平衡、步态、移动性和日常生活活动能力的结果报告有限。

结论

虚拟现实已被证明是一种安全且可行的提供癌症支持性护理的方法。虚拟现实可以在癌症护理连续体的各个阶段和环境中实施,以支持正在接受痛苦治疗的患者、化疗期间或之后以及手术干预后。虚拟现实可以作为一种有效的支持性护理干预措施,用于管理癌症患者的焦虑、疼痛和抑郁。

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