心理干预对白血病患者生活质量和心理健康的影响：一项荟萃分析。
Effect of psychological intervention on the quality of life and mental health of leukemia patients: a meta-analysis.
作者信息
Yin BingLing, Liu XiaoRong, Mao YanQin, Han YanQi
机构信息
Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Front Psychol. 2025 May 9;16:1528512. doi: 10.3389/fpsyg.2025.1528512. eCollection 2025.
BACKGROUND
Currently, chemotherapy is the main treatment for leukemia. According to relevant reports, the first remission rate of adult patients after chemotherapy is about 60-70%, and about 1/5 of patients can improve their survival time to 5 years or longer. However, due to the lengthy process of chemotherapy, various adverse reactions may occur, leading to negative emotions such as anxiety, depression, and fear in patients, reducing their compliance with chemotherapy, and posing a great physical and psychological challenge to patients. For the diagnosis and treatment of leukemia, there is a very close relationship between psychological status and treatment effectiveness. A good mentality is beneficial for patients to better cope with the disease and prolong their survival time.
METHODS
Retrieve PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang and search for randomized controlled trials (RCTs) related to the treatment of psychological intervention on the quality of life and mental health of leukemia patients published from the establishment of the library until August 2024. The retrieved literature will be independently screened by two researchers, and the methodological quality of the included literature will be evaluated using the bias risk assessment tool recommended in Cochrane 5.1 manual, followed by data statistical analysis.
RESULTS
A total of 1,792 patients were included in 18 studies. The results show the Self-Rating Anxiety Scale of the test group, which was significantly lower ( < 0.01, SMD: -6.65; 95% CI: -7.94--5.35) than the control group. Self-Rating Depression Scale of the test group was lower ( < 0.01, SMD: -7.96; 95% CI: -9.52--6.40). European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 ( < 0.01, SMD: 10.76; 95% CI: 6.27-15.24) of the test group was higher and Pittsburgh Sleep Quality Index ( < 0.01, SMD: -3.17; 95% CI: -4.68--1.67) was lower.
CONCLUSION
The results indicated that psychological intervention can improve the level of SAS, SDS, QLQ-C30, PSQI in patients with leukemia.
背景
目前，化疗是白血病的主要治疗方法。据相关报道，成年患者化疗后的首次缓解率约为60%-70%，约五分之一的患者可将生存时间提高至5年或更长。然而，由于化疗过程漫长，可能会出现各种不良反应，导致患者产生焦虑、抑郁和恐惧等负面情绪，降低其对化疗的依从性，给患者带来巨大的身心挑战。对于白血病的诊治，心理状态与治疗效果之间存在非常密切的关系。良好的心态有利于患者更好地应对疾病并延长生存时间。
方法
检索PubMed、Web of Science、Embase、Cochrane图书馆、中国知网、万方数据库，查找从建库至2024年8月发表的与心理干预对白血病患者生活质量和心理健康影响的治疗相关的随机对照试验（RCT）。检索到的文献将由两名研究人员独立筛选，采用Cochrane 5.1手册推荐的偏倚风险评估工具对纳入文献的方法学质量进行评估，随后进行数据统计分析。
结果
18项研究共纳入1792例患者。结果显示，试验组的焦虑自评量表得分显著低于对照组（<0.01，标准化均数差：-6.65；95%置信区间：-7.94至-5.35）。试验组的抑郁自评量表得分更低（<0.01，标准化均数差：-7.96；95%置信区间：-9.52至-6.40）。试验组的欧洲癌症研究与治疗组织生活质量问卷核心30项得分更高（<0.01，标准化均数差：10.76；95%置信区间：6.27至15.24），匹兹堡睡眠质量指数量表得分更低（<0.01，标准化均数差：-3.17；95%置信区间：-4.68至-1.67）。
结论
结果表明，心理干预可改善白血病患者的SAS、SDS、QLQ-C30、PSQI水平。
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