College of Nursing and Health, Henan University, Kaifeng, China.
Institution of Nursing and Health, Henan University, Kaifeng, China.
Psychooncology. 2024 Nov;33(11):e70014. doi: 10.1002/pon.70014.
This meta-analysis was to critically evaluate the effectiveness of Internet-based Cognitive Behavioral Therapy (ICBT) on psychological distress and quality of life in breast cancer survivors.
A search was conducted across eleven databases (PubMed, Web of Science, Embase, Cochrane Library, Scopus, ProQuest, CINAHL, CBM, CNKI, VIP and Wanfang) to identify relevant randomized controlled trials (RCTs) published from databases inception to September 2023. Two reviewers independently conducted study screening, data extraction, and quality assessment of the included studies. Review Manager 5.4 and Stata 18.0 were utilized for analysis.
Ten studies with 1409 patients were included. Meta-analysis indicated that ICBT alleviated anxiety [SMD = -0.34, 95% CI (-0.64, -0.04), p = 0.03] and depression [SMD = -0.43, 95% CI (-0.76, -0.09), p = 0.01] in breast cancer patients. Therapist-guided ICBT outperformed self-guided ICBT, with interventions lasting ≤ 9 weeks better than > 9 weeks, and module quantity didn't affect the results. Additionally, ICBT significantly improved quality of life [SMD = 0.37, 95% CI (0.21, 0.52), p < 0.001], yet didn't reduce fatigue [SMD = -0.13, 95% CI (-0.59, 0.34), p = 0.60], insomnia [MD = -2.24, 95% CI (-5.77, 1.28), p = 0.21], or fear of progression [SMD = -0.10, 95% CI (-0.31, 0.11), p = 0.34].
ICBT, especially therapist-guided and lasting for ≤ 9 weeks, can effectively relieve anxiety and depression, as well as enhance breast cancer patients' quality of life. Nevertheless, it fails to improve fatigue, insomnia, or fear of progression. High-quality, large-sample studies must be conducted in the future for further validation.
本荟萃分析旨在批判性评估基于互联网的认知行为疗法（ICBT）对乳腺癌幸存者心理困扰和生活质量的有效性。
在 11 个数据库（PubMed、Web of Science、Embase、Cochrane 图书馆、Scopus、ProQuest、CINAHL、CBM、CNKI、VIP 和万方）中进行了检索，以确定从数据库创建到 2023 年 9 月发表的相关随机对照试验（RCT）。两位审查员独立进行了研究筛选、数据提取和纳入研究的质量评估。使用 Review Manager 5.4 和 Stata 18.0 进行分析。
纳入了 10 项研究，共 1409 名患者。荟萃分析表明，ICBT 缓解了乳腺癌患者的焦虑[SMD=-0.34，95%CI（-0.64，-0.04），p=0.03]和抑郁[SMD=-0.43，95%CI（-0.76，-0.09），p=0.01]。治疗师指导的 ICBT 优于自我指导的 ICBT，干预持续时间≤9 周优于>9 周，模块数量不影响结果。此外，ICBT 显著改善了生活质量[SMD=0.37，95%CI（0.21，0.52），p<0.001]，但没有降低疲劳[SMD=-0.13，95%CI（-0.59，0.34），p=0.60]、失眠[MD=-2.24，95%CI（-5.77，1.28），p=0.21]或对进展的恐惧[SMD=-0.10，95%CI（-0.31，0.11），p=0.34]。
ICBT，特别是治疗师指导的、持续时间≤9 周的 ICBT，可以有效缓解焦虑和抑郁，同时提高乳腺癌患者的生活质量。然而，它不能改善疲劳、失眠或对进展的恐惧。未来必须进行高质量、大样本的研究以进一步验证。
