认知行为疗法对成年癌症患者心理弹性的影响：一项系统评价与荟萃分析
Effects of cognitive behavioral therapy on resilience among adult cancer patients: a systematic review and meta-analysis.
作者信息
Xiang Lina, Wan Hongwei, Zhu Yu
机构信息
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Nursing, Shanghai Proton and Heavy Ion Center, Shanghai, 201315, China.
出版信息
BMC Psychiatry. 2025 Mar 6;25(1):204. doi: 10.1186/s12888-025-06628-3.
BACKGROUND
Psychological resilience refers to maintaining or regaining psychological well-being after experiencing adversity, trauma, or stress. There is evidence suggesting that cognitive behavioral therapy (CBT) can significantly enhance an individual's coping skills. However, the overall effectiveness of CBT on resilience among cancer patients remains unclear. Therefore, this study systematically evaluated the impact of CBT on resilience among cancer patients.
METHODS
The PubMed, PsycINFO, Cochrane Library, CINAHL, and Embase databases were searched using keywords. Two researchers independently conducted a rigorous evaluation of the quality of the evidence using the GRADE system and independently performed data extraction. A meta-analysis was conducted to calculate the experimental group's effect size and to explore the effects of CBT on enhancing resilience.
RESULTS
Thirteen randomized controlled trials (RCTs) were included in this meta-analysis. The effect of CBT on increasing resilience among cancer patients was small but significant immediately after the intervention (g = 1.211; p < 0.001). The results showed that CBT delivered via mobile devices was more effective than face-to-face CBT (β = 0.284; P = 0.012). Additionally, group CBT also outperformed individual CBT (β = 0.181; P = 0.042). Furthermore, CBT was more effective among patients with existing tumors (β = 0.285; P = 0.037). The evidence regarding the effects of CBT on resilience was found to be of moderate strength.
CONCLUSIONS
The results of this study indicate CBT can improve resilience among cancer patients. These findings underscore the importance of considering delivery methods and formats when implementing CBT interventions, with mobile device delivery and group formats resulting in better outcomes. The positive effects of CBT on patients with existing tumors highlight the importance of delivering this therapy in specific clinical contexts. Overall, this study provided moderately strong evidence that CBT is a valuable tool for enhancing resilience among cancer patients.
TRIAL REGISTRATION
CRD42021256841.
背景
心理韧性是指在经历逆境、创伤或压力后维持或恢复心理健康。有证据表明，认知行为疗法（CBT）可显著提高个体的应对技能。然而，CBT对癌症患者心理韧性的总体效果仍不明确。因此，本研究系统评估了CBT对癌症患者心理韧性的影响。
方法
使用关键词检索PubMed、PsycINFO、Cochrane图书馆、CINAHL和Embase数据库。两名研究人员独立使用GRADE系统对证据质量进行严格评估，并独立进行数据提取。进行荟萃分析以计算实验组的效应量，并探讨CBT对增强心理韧性的影响。
结果
本荟萃分析纳入了13项随机对照试验（RCT）。干预后，CBT对提高癌症患者心理韧性的效果较小但显著（g = 1.211；p < 0.001）。结果表明，通过移动设备提供的CBT比面对面的CBT更有效（β = 0.284；P = 0.012）。此外，团体CBT也优于个体CBT（β = 0.181；P = 0.042）。此外，CBT对现有肿瘤患者更有效（β = 0.285；P = 0.037）。关于CBT对心理韧性影响的证据被发现具有中等强度。
结论
本研究结果表明CBT可提高癌症患者的心理韧性。这些发现强调了在实施CBT干预时考虑提供方式和形式的重要性，移动设备提供和团体形式可产生更好的效果。CBT对现有肿瘤患者的积极影响突出了在特定临床环境中提供这种疗法的重要性。总体而言，本研究提供了中等强度的证据，表明CBT是增强癌症患者心理韧性的有价值工具。
试验注册
CRD42021256841。
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