Bu Xiaofan, Jiang Ling, Leung Doris Y P
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
Department of Nursing, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
J Clin Nurs. 2025 Sep;34(9):3504-3518. doi: 10.1111/jocn.17790. Epub 2025 May 14.
Family strengths can be used to help families adapt to hardship and strain. However, meta-analytic evidence of the effectiveness of family involvement interventions on fear of cancer recurrence (FCR) in women with breast cancer and their caregivers is lacking.
To evaluate the effectiveness of family involvement interventions on FCR in women with breast cancer and their caregivers and to identify the characteristics of effective family involvement interventions.
Ten electronic databases were searched from database inception to October 2023. The updated Cochrane risk-of-bias tool was used to assess the quality of the included randomised controlled trials (RCTs). Data analyses were executed with Revman 5.3 software, and subgroup analyses were performed on the basis of interventional dosage. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 checklist was employed to provide guidance.
Seven studies were included in the review, and six were included in the meta-analysis. The main contents included content related to the disclosure of disease-related feelings/worries/concerns/experiences, education/psychological support plus some disclosure and education/counselling based on disclosure content. The results of the meta-analysis showed that family involvement interventions have large short-term positive effects on relieving FCR in women with breast cancer. The pooled results of subgroup analysis demonstrated that compared with usual care, education/psychological support plus some disclosure is ineffective, and disclosure alone has a moderate-to-large effect size, whereas disclosure with education or counselling targeting the specific needs of participants has an extremely large effect size. Only one study focused on FCR in caregivers, with an unfavourable result.
Family involvement interventions, especially those using disclosure combined with education or counselling targeting their specific needs, have considerable short-term effects on women's FCR alleviation. However, the evidence in caregivers is insufficient. Only a few interventional studies targeting patients and caregivers exist. Further high-quality RCTs with follow-ups are encouraged.
No patient or public contribution.
家庭优势可用于帮助家庭适应困难和压力。然而，缺乏关于家庭参与干预对乳腺癌女性患者及其照顾者癌症复发恐惧（FCR）有效性的荟萃分析证据。
评估家庭参与干预对乳腺癌女性患者及其照顾者FCR的有效性，并确定有效家庭参与干预的特征。
检索了从数据库建立到2023年10月的10个电子数据库。使用更新后的Cochrane偏倚风险工具评估纳入的随机对照试验（RCT）的质量。使用Revman 5.3软件进行数据分析，并根据干预剂量进行亚组分析。采用系统评价和荟萃分析的首选报告项目2020清单提供指导。
该综述纳入了7项研究，荟萃分析纳入了6项研究。主要内容包括与疾病相关感受/担忧/关切/经历的披露、教育/心理支持以及基于披露内容的一些披露和教育/咨询。荟萃分析结果表明，家庭参与干预对缓解乳腺癌女性患者的FCR有较大的短期积极影响。亚组分析的汇总结果表明，与常规护理相比，教育/心理支持加一些披露无效，仅披露有中度至较大的效应量，而针对参与者特定需求的披露与教育或咨询相结合有极大的效应量。只有一项研究关注照顾者的FCR，结果不理想。
家庭参与干预，尤其是那些将披露与针对其特定需求的教育或咨询相结合的干预，对缓解女性的FCR有相当大的短期效果。然而，照顾者方面的证据不足。针对患者和照顾者的干预研究很少。鼓励开展进一步的高质量随访RCT。
无患者或公众参与。
