Tang Wen-Zhen, Cheng Shi-Li, Mangantig Ernest, Yulita Hanum P Iskandar, Jia Kui, Yusuf Azlina
School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, KTN, Malaysia.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Naning, GX, People's Republic of China.
Palliat Support Care. 2025 Jan 20;23:e16. doi: 10.1017/S1478951524001597.
Demoralization isa common psychological problem in cancer patients. The purpose of this study is to systematically evaluate the correlated factors of demoralization among cancer patients. We also summarized the available evidence, effect estimates, and the strength of statistical associations between demoralization and its associated factors.
We systematically searched PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, PsycINFO, and 2 electronic databases to identify studies published up to October 2023 with data on the correlates of demoralization. Two researchers independently reviewed references, extracted data, and assessed data quality. Meta-analysis was performed using R4.1.1 software.
Thirty-eight studies were included in this meta-analysis. For the most studied sociodemographic correlates, demoralization was negatively correlated with income ( = -0.29, 95% CI: -0.51, -0.02), education ( = - 0.11, 95% CI: - 0.16, -0.05), and age ( = -0.45, 95%CI: -0.75, -0.01). For the most studied clinical correlates, demoralization was positively correlated with symptom burden (z = 0.37, 95% CI: 0.22, 0.50) and negatively correlated with quality of life ( = -0.40, 95% CI: -0.54, -0.24). For the most studied psychosocial correlates, demoralization was negatively correlated with social support ( = -0.39, 95% CI: -0.51, -0.26) and positively correlated with anxiety ( = 0.65, 95% CI: 0.56, 0.73), depression ( = 0.61, 95% CI: 0.54, 0.67), and suicidal ideation ( = 0.48, 95% CI: 0.34, 0.60).
Demoralization showed either positive or negative associations with sociodemographic, clinical, and psychological variables. More research is needed to explore the underlying mechanisms to develop effective interventions. This review provides information on the factors associated with demoralization in cancer patients, which can be used to inform strategies for clinical care providers.
意志消沉是癌症患者常见的心理问题。本研究旨在系统评估癌症患者意志消沉的相关因素。我们还总结了现有证据、效应估计值以及意志消沉与其相关因素之间的统计关联强度。
我们系统检索了PubMed、科学网、CINAHL、Embase、考克兰图书馆、PsycINFO以及两个电子数据库，以识别截至2023年10月发表的有关意志消沉相关因素的数据的研究。两名研究人员独立查阅参考文献、提取数据并评估数据质量。使用R4.1.1软件进行荟萃分析。
本荟萃分析纳入了38项研究。在研究最多的社会人口学相关因素方面，意志消沉与收入呈负相关（ = -0.29，95%置信区间：-0.51，-0.02）、与教育程度呈负相关（ = -0.11，95%置信区间：-0.16，-0.05）、与年龄呈负相关（ = -0.45，95%置信区间：-0.75，-0.01）。在研究最多的临床相关因素方面，意志消沉与症状负担呈正相关（z = 0.37，95%置信区间：0.22，0.50）、与生活质量呈负相关（ = -0.40，95%置信区间：-0.54，-0.24）。在研究最多的心理社会相关因素方面，意志消沉与社会支持呈负相关（ = -0.39，95%置信区间：-0.51，-0.26）、与焦虑呈正相关（ = 0.65，95%置信区间：0.56，0.73）、与抑郁呈正相关（ = 0.61，95%置信区间：0.54，0.67）、与自杀意念呈正相关（ = 0.48，95%置信区间：0.34，0.60）。
意志消沉与社会人口学、临床和心理变量之间呈现出正相关或负相关。需要更多研究来探索潜在机制以制定有效的干预措施。本综述提供了与癌症患者意志消沉相关的因素信息，可用于为临床护理人员提供策略参考。
