Zhang Tao, Ren Zhihong, Wakefield Claire Elizabeth, Hui Bryant Pui Hung, Akechi Tatsuo, Shi Congrong, Du Xiayu, Chen Wenke, Lai Lizu, Zhao Chunxiao, Li Ying, Zhou Yubu
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China; Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR.
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China.
Clin Psychol Rev. 2025 Feb;115:102520. doi: 10.1016/j.cpr.2024.102520. Epub 2024 Nov 26.
Many cancer patients experience psychological distress and/or poor quality of life during or after their cancer treatment, yet they face multiple barriers to accessing psychological support. Digital psychological interventions represent a promising approach for addressing these barriers, however their comparative effectiveness remains uncertain.
Nine databases were searched for randomized controlled trials (RCTs) from inception to July 2024. The primary outcomes were psychological distress and quality of life, and the secondary outcomes were measures of depression, anxiety, insomnia, fatigue, and fear of cancer recurrence in this study.
One hundred and thirty-six RCTs with 23,154 participants were identified. Of these interventions, three types-digitally-delivered cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT)-demonstrated significant reductions in psychological distress compared to non-active controls. Digital CBT, narrative interventions, and VRT significantly improved quality of life compared to non-active controls. For depression, both digital CBT and VRT were superior to the non-active control group. Regarding anxiety, CBT, psychoeducation, and VRT outperformed the non-active control group. In terms of fatigue, CBT, psychoeducation, VRT, and multi-component interventions all showed enhanced efficacy compared to the non-active control group. However, only CBT exhibited significantly superior effectiveness in alleviating insomnia compared to non-active controls. Similarly, only mindfulness-based interventions significantly reduced fear of cancer recurrence compared to the non-active control condition.
Our results suggest that digital CBT and VRT are highly promising options for reducing psychological distress and enhancing the quality of life among cancer patients; further high-quality randomized controlled trials involving diverse populations are essential to validate these findings.
许多癌症患者在癌症治疗期间或之后会经历心理困扰和/或生活质量低下的情况，但他们在获得心理支持方面面临多重障碍。数字心理干预是解决这些障碍的一种有前景的方法，然而它们的相对有效性仍不确定。
检索了九个数据库，以查找从数据库建立到2024年7月的随机对照试验（RCT）。本研究的主要结局是心理困扰和生活质量，次要结局是抑郁、焦虑、失眠、疲劳以及对癌症复发的恐惧的测量指标。
共识别出136项RCT，涉及23,154名参与者。在这些干预措施中，与非主动对照组相比，三种类型——数字交付的认知行为疗法（CBT）、健康教育和虚拟现实疗法（VRT）——显示出心理困扰显著降低。与非主动对照组相比，数字CBT、叙事干预和VRT显著改善了生活质量。对于抑郁，数字CBT和VRT均优于非主动对照组。关于焦虑，CBT、心理教育和VRT的效果优于非主动对照组。在疲劳方面，与非主动对照组相比，CBT、心理教育、VRT和多成分干预措施均显示出增强的疗效。然而，与非主动对照组相比，只有CBT在缓解失眠方面表现出显著更优的效果。同样，与非主动对照条件相比，只有基于正念的干预措施显著降低了对癌症复发的恐惧。
我们的结果表明，数字CBT和VRT是减轻癌症患者心理困扰和提高生活质量的非常有前景的选择；进一步开展涉及不同人群的高质量随机对照试验对于验证这些发现至关重要。
