Han Jianlong, Ding Yunxin, Wang Hongwei, Li Qing, Zhai Huanqie, He Shuling
Jiamusi University School of Clinical Medicine, Jiamusi University, Jiamusi, China.
Tianjin Mental Health Center, Tianjin, China.
Front Oncol. 2024 Oct 8;14:1434581. doi: 10.3389/fonc.2024.1434581. eCollection 2024.
Internet-based cognitive behavioral therapy(ICBT) improves the impact of breast cancer through online platforms, modular learning, goal setting, relaxation exercises, and other techniques. Compared to traditional cognitive behavioral therapy (CBT), ICBT offers advantages such as the convenience of flexible time and location choices and reduced manpower requirements. In recent years, research exploring the impact of ICBT on breast cancer patients has been increasing, with conflicting results across different studies. Therefore, the purpose of this study was to comprehensively examine the impact of ICBT on the psychological health and quality of life of breast cancer patients through a systematic review and meta-analysis.
We searched ten databases in both English and Chinese, with the search period extending from the inception of the databases to December 30, 2023. Literature screening, bias risk assessment, data extraction, and evidence level evaluation were independently conducted by two researchers. All the data were analyzed using RevMan 5.4 and Stata 17.0 software.
A total of 2079 breast cancer patients were included in this study, of which 1171 patients received ICBT treatment. The results show that ICBT can reduce anxiety [SMD=-0.19, 95%CI (-0.37, -0.01), P=0.0008] and depression [SMD=-0.20, 95%CI (-0.37, -0.02), P=0.001], alleviate fatigue [SMD=-0.34, 95%CI (-0.67, -0.01), P=0.04], and improve quality of life [SMD=0.20, 95% CI (0.03, 0.38), P=0.02] in breast cancer patients. However, the intervention effects of ICBT on insomnia [SMD=-0.44, 95%CI (-0.93, 0.06), P=0.08] and sleep quality [SMD=-0.14, 95%CI (-0.30, 0.01), P=0.06] in breast cancer patients are not significant. The subgroup analysis showed that when the intervention period is longer than 8 weeks, the number of intervention modules exceeds 6, and a waitlist control group is included, there is a significant effect on reducing patients' anxiety and depression. However, the method of guidance and whether the intervention period exceeds 12 weeks are not related.
ICBT can alleviate anxiety and depression in breast cancer patients, with the intervention effects being independent of the guidance method. Significant results were obtained when the intervention period was >8 weeks and the number of modules was >6. ICBT can reduce fatigue and improve quality of life in breast cancer patients, but its impact on sleep quality was not significant. More high-quality research is needed in the future.
PROSPERO, identifier CRD42024494744.
基于互联网的认知行为疗法（ICBT）通过在线平台、模块化学习、目标设定、放松练习及其他技术改善乳腺癌的影响。与传统认知行为疗法（CBT）相比，ICBT具有诸如时间和地点选择灵活方便以及人力需求降低等优势。近年来，探索ICBT对乳腺癌患者影响的研究不断增加，但不同研究结果相互矛盾。因此，本研究旨在通过系统评价和荟萃分析全面考察ICBT对乳腺癌患者心理健康和生活质量的影响。
我们检索了中英文十个数据库，检索期从数据库创建至2023年12月30日。两名研究人员独立进行文献筛选、偏倚风险评估、数据提取和证据水平评估。所有数据使用RevMan 5.4和Stata 17.0软件进行分析。
本研究共纳入2079例乳腺癌患者，其中1171例患者接受ICBT治疗。结果显示，ICBT可降低乳腺癌患者的焦虑[标准化均数差（SMD）=-0.19，95%置信区间（CI）（-0.37，-0.01），P = 0.0008]和抑郁[SMD=-0.20，95%CI（-0.37，-0.02），P = 0.001]，减轻疲劳[SMD=-0.34，95%CI（-0.67，-0.01），P = 0.04]，并改善生活质量[SMD = 0.20，95%CI（0.03，0.38），P = 0.02]。然而，ICBT对乳腺癌患者失眠[SMD=-0.44，95%CI（-0.93，0.06），P = 0.08]和睡眠质量[SMD=-0.14，95%CI（-0.30，0.01），P = 0.06]的干预效果不显著。亚组分析表明，当干预期超过8周、干预模块数超过6个且纳入等待名单对照组时，对降低患者焦虑和抑郁有显著效果。然而，指导方法和干预期是否超过12周无关。
ICBT可减轻乳腺癌患者的焦虑和抑郁，干预效果与指导方法无关。当干预期>8周且模块数>6时可获得显著结果。ICBT可降低乳腺癌患者的疲劳并改善生活质量，但其对睡眠质量的影响不显著。未来需要更多高质量研究。
PROSPERO，标识符CRD42024494744
