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基于网络的干预措施对乳腺癌患者生活质量的影响:一项随机对照试验的系统评价和荟萃分析。

Effects of web-based interventions on quality of life among patients with breast cancer: A systematic review and meta-analysis of randomized controlled trials.

机构信息

School of Nursing, Lineberger Cancer Institute, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.

College of Nursing, Kangwon National University, Chuncheon, Republic of Korea.

出版信息

Cancer Med. 2024 Sep;13(18):e70230. doi: 10.1002/cam4.70230.

Abstract

OBJECTIVE

Patients with breast cancer experience decreased quality of life due to various physical and psychological challenges. Web-based interventions are accessible, cost-effective, and convenient for improving their quality of life. This study evaluated whether web-based interventions improve quality of life and included only randomized controlled trials (RCTs) with clear evidence.

METHODS

PubMed, Embase, Cochrane Library, CINAHL, Web of Science, and PsycINFO were searched for articles published until October 16, 2023. Inclusion criteria were RCTs evaluating the effect of web-based interventions on quality of life in patients with breast cancer. The risk of bias was assessed with Cochrane's Risk of Bias Tool 2.0. Standardized mean differences were calculated with a random effects model using R version 4.0.3, and subgroup and moderator analyses were performed.

RESULTS

Since quality of life was measured using two different instruments in two studies, 21 comparisons were analyzed from 19 RCTs. As a result, the findings suggest that web-based interventions have a small effect size on improving the quality of life for patients with breast cancer (SMD = 0.27, 95% confidence intervals [CIs]: 0.15-0.38, p = 0.03). Heterogeneity was found to be low (I = 40%). The quality-of-life subdomain results showed a moderate effect size on the physical functioning and a small effect size on the cognitive and emotional functioning of patients with breast cancer but no significant impact on their role or social functioning.

CONCLUSIONS

Web-based interventions are effective in improving patients' quality of life with breast cancer; they also improve physical, cognitive, and emotional functioning. However, evidence regarding intervention methods remains inconclusive due to the limited number of RCTs, necessitating further research.

摘要

目的

乳腺癌患者会因各种身体和心理挑战而降低生活质量。基于网络的干预措施具有可及性、成本效益和便利性,可以改善他们的生活质量。本研究评估了基于网络的干预措施是否可以改善生活质量,并且只纳入了具有明确证据的随机对照试验(RCT)。

方法

检索了 PubMed、Embase、Cochrane 图书馆、CINAHL、Web of Science 和 PsycINFO 数据库,截至 2023 年 10 月 16 日,收录了评估基于网络的干预措施对乳腺癌患者生活质量影响的 RCT 文章。采用 Cochrane 偏倚风险工具 2.0 评估偏倚风险。使用 R 版本 4.0.3 计算基于随机效应模型的标准化均数差,并进行亚组和调节因素分析。

结果

由于两项研究中生活质量使用了两种不同的工具进行测量,因此从 19 项 RCT 中分析了 21 项比较。结果表明,基于网络的干预措施对改善乳腺癌患者生活质量具有较小的效应量(SMD=0.27,95%置信区间:0.15-0.38,p=0.03)。异质性较低(I=40%)。生活质量亚组结果显示,基于网络的干预措施对乳腺癌患者的身体功能具有中度效应量,对认知和情绪功能具有较小的效应量,但对角色和社会功能没有显著影响。

结论

基于网络的干预措施可有效改善乳腺癌患者的生活质量,改善其身体、认知和情绪功能。然而,由于 RCT 数量有限,干预方法的证据仍不明确,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e312/11447276/5b4bc0bdbda9/CAM4-13-e70230-g003.jpg

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