Dong Mengyuan, Huang Yongqi, Zhang Xuan, Wu Liuliu, Ghazal Lubna, Cao Fenglin
School of Nursing and Rehabilitation, Shandong University, Jinan, China.
Psychooncology. 2025 May;34(5):e70166. doi: 10.1002/pon.70166.
Digital health technology (DHT)-based psychological interventions are emerging as a means to enhance psychological outcomes for cancer survivors. This study aims to assess the effects of DHT-based psychological interventions on anxiety, depression, sleep disturbances, fatigue, and quality of life among cancer survivors.
A systematic search was conducted in PubMed, Web of Science, the Cochrane Library, and Embase. The Cochrane risk-of-bias tool RoB 2 was used to evaluate the quality of the included studies. The Template for Intervention Description and Replication (TIDieR) checklist was used to check if the interventions reviewed were described in detail to be implemented in the clinical setting. Data synthesis was conducted in Review Manager (Version 5.4), and the effect size was calculated by the standardized mean difference and its 95% confidence interval. Sensitivity analysis and subgroup analysis were also conducted. The certainty of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation approach.
This meta-analysis encompassed 46 randomized controlled trials, involving 5211 participants. DHT-based psychological interventions significantly reduced anxiety (SMD = -0.41, 95% CI -0.59/-0.24), depression (SMD = -0.26, 95% CI -0.39/-0.13), sleep disturbance (SMD = -0.39, 95% CI -0.64/-0.14), fatigue (SMD = -0.47, 95% CI -0.77/-0.17), and improved quality of life (SMD = 0.42, 95% CI 0.22/0.62). Subgroup analysis indicated that interventions lasting for a duration of ≥ 12 weeks, and integrated interventions might be the most effective in addressing adverse psychological outcomes. And cognitive-behavioral therapy interventions demonstrated significant effectiveness in managing sleep disturbance.
DHT-based psychological interventions might be effective for improving anxiety, depression, sleep disturbances, fatigue, and quality of life in cancer survivors. We cannot draw definitive conclusions due to intervention and study design heterogeneity. Further rigorous trials are crucial to identify optimal interventions for different types of cancers, determine suitable durations, specify types of DHT-based psychological interventions and validate intervention therapies.
基于数字健康技术（DHT）的心理干预正逐渐成为改善癌症幸存者心理状况的一种手段。本研究旨在评估基于DHT的心理干预对癌症幸存者焦虑、抑郁、睡眠障碍、疲劳及生活质量的影响。
在PubMed、科学网、考克兰图书馆和Embase中进行系统检索。使用考克兰偏倚风险工具RoB 2评估纳入研究的质量。使用干预描述与复制模板（TIDieR）清单检查所综述的干预措施是否有详细描述以便在临床环境中实施。在Review Manager（5.4版）中进行数据合成，并通过标准化均数差值及其95%置信区间计算效应量。还进行了敏感性分析和亚组分析。使用推荐分级、评估、制定与评价方法对证据的确定性进行评级。
本荟萃分析纳入46项随机对照试验，涉及5211名参与者。基于DHT的心理干预显著降低了焦虑（标准化均数差值[SMD]= -0.41，95%置信区间[-0.59/-0.24]）、抑郁（SMD = -0.26，95%置信区间[-0.39/-0.13]）、睡眠障碍（SMD = -0.39，95%置信区间[-0.64/-0.14]）、疲劳（SMD = -0.47，95%置信区间[-0.77/-0.17]），并改善了生活质量（SMD = 0.42，95%置信区间[0.22/0.62]）。亚组分析表明，持续时间≥12周的干预措施以及综合干预措施可能在解决不良心理结局方面最有效。认知行为疗法干预在管理睡眠障碍方面显示出显著效果。
基于DHT的心理干预可能对改善癌症幸存者的焦虑、抑郁、睡眠障碍、疲劳及生活质量有效。由于干预措施和研究设计的异质性，我们无法得出明确结论。进一步的严格试验对于确定针对不同类型癌症的最佳干预措施、确定合适的持续时间、明确基于DHT的心理干预类型以及验证干预疗法至关重要。
