针对前列腺癌患者及其非正式照护者健康结局的二元干预措施的有效性：一项系统评价与荟萃分析。
The effectiveness of dyadic interventions for health outcomes of prostate cancer patients and informal caregivers: a systematic review and meta-analysis.
作者信息
Xiao Yuan, Sun Jiao, Liu Min, Wang Haifeng, Guan Jingjing
机构信息
School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, 130021, People's Republic of China.
First Hospital of Jilin University, No.1 Xinmin Street, Changchun, Jilin, 130021, People's Republic of China.
出版信息
BMC Nurs. 2025 Feb 3;24(1):119. doi: 10.1186/s12912-025-02769-8.
BACKGROUND
Prostate cancer is a worldwide health issue, and current prostate cancer care extends to the patient‒caregiver dyadic setting, where individuals are interdependent and interact with each other as well as possible negative psychological and behavioural outcomes. However, the impact of dyadic care interventions on health outcome indicators for prostate cancer patients and their informal caregivers has yet to be examined.
AIM
To describe the characteristics of dyadic interventions involving patients with prostate cancer and their informal caregivers and investigate their effects on psychosocial health, sexual health, and dyadic relationships.
METHODS
Ten electronic databases (Web of Science, Cochrane Library, PsycINFO, PubMed, Embase, CINAHL, CNKI, Wanfang, VIP, and SinoMed) were thoroughly searched for related publications published between the database's founding and April 2024. The risk of bias for the included studies was evaluated using the Cochrane risk-of-bias tool, and a meta-analysis was performed using RevMan 5.4.
RESULTS
This study identified and evaluated 19 RCTs reporting 22 different interventions, as well as outcome indicators for the three aspects of psychosocial health, sexual health, and dyadic relationships in prostate cancer patients and informal caregivers. A meta-analysis of pooled data revealed that for prostate cancer patients, the intervention improved dyadic coping (SMD95% CI [95% CI] = 0.22 [0.01;0.42], p = 0.04), and for informal caregivers the dyadic care intervention reduced anxiety (SMD95% CI [95% CI] = -0.35 [-0.65;-0.06], p = 0.02), enhanced self-efficacy (SMD [95% CI] = 0.22 [0.01;0.43], p = 0.04), and improved sexual functioning (SMD [95% CI] = 0.29 [0.05;0.54], p = 0.02). No statistically significant overall effects were observed for the other outcome indicators.
CONCLUSION
The results of this review indicate that dyadic care interventions benefit prostate cancer patients and informal caregivers. However, given features such as research quality and sample size, further randomized controlled trials with excellent study designs are needed in the future to evaluate and validate the efficacy of dyadic care treatments for patients with prostate cancer.
TRIAL REGISTRATION
The protocol for this study is registered in PROSPERO with registration number (CRD42024567542).
背景
前列腺癌是一个全球性的健康问题，目前前列腺癌护理已扩展到患者-照护者二元环境，在此环境中个体相互依存、相互影响，可能产生负面心理和行为结果。然而，二元护理干预对前列腺癌患者及其非正式照护者健康结局指标的影响尚未得到研究。
目的
描述涉及前列腺癌患者及其非正式照护者的二元干预特征，并调查其对心理社会健康、性健康和二元关系的影响。
方法
全面检索了10个电子数据库（科学引文索引、考克兰图书馆、心理学文摘数据库、医学期刊数据库、荷兰医学文摘数据库、护理学与健康领域数据库、中国知网、万方数据、维普资讯和中国生物医学文献数据库），以查找在数据库建立至2024年4月期间发表的相关出版物。使用考克兰偏倚风险工具评估纳入研究的偏倚风险，并使用RevMan 5.4进行荟萃分析。
结果
本研究识别并评估了19项随机对照试验，这些试验报告了22种不同干预措施，以及前列腺癌患者和非正式照护者心理社会健康、性健康和二元关系三个方面的结局指标。对汇总数据的荟萃分析显示，对于前列腺癌患者，干预改善了二元应对（标准化均数差95%置信区间[95%CI]=0.22[0.01；0.42]，p=0.04）；对于非正式照护者，二元护理干预降低了焦虑（标准化均数差95%置信区间[95%CI]=-0.35[-0.65；-0.06]，p=0.02），增强了自我效能感（标准化均数差[95%CI]=0.22[0.01；0.43]，p=0.04），并改善了性功能（标准化均数差[95%CI]=0.29[0.05；0.54]，p=0.02）。其他结局指标未观察到具有统计学意义的总体效应。
结论
本综述结果表明，二元护理干预对前列腺癌患者和非正式照护者有益。然而，考虑到研究质量和样本量等因素，未来需要进一步开展设计优良的随机对照试验，以评估和验证二元护理治疗对前列腺癌患者的疗效。
试验注册
本研究方案已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为（CRD42024567542）。
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