Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241276232. doi: 10.1177/17455057241276232.
During neoadjuvant therapy (NAT), patients with locally advanced breast cancer (LABC) experience psychological distress (PD) and adopt appropriate coping strategies.
This systematic review aimed to examine the prevalence and changes in PD and coping strategies in patients with LABC during NAT and to evaluate effective interventions to reduce their PD.
Quantitative (cross-sectional, longitudinal, and interventional) and qualitative studies reporting PD and coping strategies related to NAT during LABC were included.
PubMed, Cochrane Library, Scopus, ScienceDirect, Wiley Online Library, and Web of Science databases were consulted to gather relevant literature from the first publications until July 25, 2023. Selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
A total of 41 articles were included, of which four were qualitative. The main results showed that the prevalence of depression before NAT ranged from 0% to 46% and that of anxiety from 5.5% to 54%. After NAT, the prevalence of depression ranged from 40% to 78.5% and anxiety accounted for 27%. Additionally, PD decreased during NAT. The main determinants of PD were perceived social support, living in joint families, being affected by COVID-19 infection, delays in diagnosis, and starting neoadjuvant treatment. For coping strategies, after NAT, "resigned coping" decreased, whereas "social support" increased, and active coping strategies were correlated with better PD. Some interventions found a reduction in PD, such as a mobile health application, fasting-mimicking diet, relaxation training, and guided imaging.
These findings highlight the importance of considering PD and coping strategies in patients with LABC from diagnosis to the end of NAT. The results suggest that effective psychological interventions should be implemented.
在新辅助治疗（NAT）期间，局部晚期乳腺癌（LABC）患者会经历心理困扰（PD），并采取适当的应对策略。
本系统综述旨在检查 LABC 患者在 NAT 期间 PD 和应对策略的发生率和变化，并评估有效干预措施以降低其 PD。
纳入报告与 LABC 期间 NAT 相关的 PD 和应对策略的定量（横断面、纵向和干预性）和定性研究。
通过检索 PubMed、Cochrane 图书馆、Scopus、ScienceDirect、Wiley Online Library 和 Web of Science 数据库，收集从首次发表至 2023 年 7 月 25 日的相关文献。根据系统评价和荟萃分析的首选报告项目指南进行选择。
共纳入 41 篇文章，其中 4 篇为定性研究。主要结果显示，NAT 前抑郁的发生率为 0%至 46%，焦虑的发生率为 5.5%至 54%。NAT 后，抑郁的发生率为 40%至 78.5%，焦虑占 27%。此外，PD 在 NAT 期间下降。PD 的主要决定因素包括感知社会支持、与家人同住、受到 COVID-19 感染的影响、诊断延迟和开始新辅助治疗。对于应对策略，NAT 后，“听天由命的应对”减少，而“社会支持”增加，积极的应对策略与更好的 PD 相关。一些干预措施发现 PD 降低，例如移动健康应用程序、模拟禁食饮食、放松训练和指导成像。
这些发现强调了在从诊断到 NAT 结束期间考虑 LABC 患者的 PD 和应对策略的重要性。结果表明，应实施有效的心理干预措施。
