认知行为疗法对癌症复发恐惧干预效果的meta分析  

A meta-analysis of effect of cognitive behavioral therapy on fear of cancer recurrence

作　　者：项李娜 朱毓 万宏伟 张丽娟 郑咪咪 李小茹 王姝曼 XIANG Lina;ZHU Yu;WAN Hongwei;ZHANG Lijuan;ZHENG Mimi;LI Xiaoru;WANG Shuman(Department of Nursing,Shanghai Proton and Heavy Ion Center,Fudan University Cancer Hospital,China,Shanghai Key Laboratory of radiation oncology(20dz2261000),Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201321,China)

机构地区：[1]上海市质子重离子医院护理部,复旦大学附属肿瘤医院护理部,上海市放射肿瘤学重点实验室(20dz2261000),上海质子重离子放射治疗工程技术研究中心,上海201321

出　　处：《中国心理卫生杂志》2023年第8期687-693,共7页Chinese Mental Health Journal

基　　金：上海市浦东新区科技发展基金民生科研专项“基于积极心理学的正念训练对粒子治疗肿瘤患者心理康复的影响”(PKJ2020-Y57);复旦大学-复星护理科研基金“基于正念的被动音乐训练对肿瘤患者粒子治疗时焦虑抑郁情绪的影响”(FNF202129),复旦大学-复星护理科研基金“团体认知行为疗法对减轻鼻咽癌患者癌症复发恐惧的影响研究”(FNF202104)。

摘　　要：目的:评价认知行为疗法对癌症复发恐惧的治疗效果。方法:检索中国期刊网全文数据库(CNKI)、万方数据库、Pubmed、EMBASE、Web of Science、CINAHL、Cochrane等数据库中有关认知行为疗法对癌症复发恐惧的随机对照试验,运用stata15.0软件进行meta分析。结果:纳入19项随机对照实验或类实验研究,meta分析显示认知行为疗法对减轻癌症复发恐惧有显著效果(Hedges′s=15.76,95%CI:-0.81~-0.63,P<0.001),且干预后6个月仍有效果(Hedges′s=3.22,95%CI:-0.64~-0.23,P<0.001)。认知行为疗法以团体形式、面对面模式、总时长在6~8周、单次时长大于90 min对减轻癌症复发恐惧效果最佳(均P<0.001)。结论:认知行为疗法可降低癌症复发恐惧水平,且不同干预模式、形式、单次时长和总时长的认知行为疗法对复发恐惧水平效果存在一定差异。Objective:To systematically evaluate the effect of cognitive behavioral therapy on the fear of cancer recurrence.Methods:CNKI,Pubmed,EMBASE,Web of Science were searched for randomized controlled trials of cognitive behavioral therapy on fear of cancer recurrence by using computer system.Stata 15.0 software was used for meta-analysis of cognitive behavioral therapy′s influence on fear of cancer recurrence.Results:This systematic review included 19 randomized controlled trials.The results of meta-analysis showed that cognitive behavioral therapy had a significant effect on reducing the fear of cancer recurrence(Hedges′s=15.76,95%CI:-0.81--0.63,P0.001),and the effect was still effective 6 months after the intervention(Hedges′s=15.76,95%CI:-0.81--0.63,P0.001).Cognitive-behavioral therapy was most effective in reducing fear of cancer recurrence in a group setting,in a face-to-face format,for a total duration of 6-8 weeks,and for a single session longer than 90 min(Ps0.001).Conclusion:Cognitive behavioral therapy could significantly reduce the level of fear of recurrence in cancer patients.

关 键 词：癌症 恐惧 复发 认知 行为 META分析 

分 类 号：R395.2[哲学宗教—心理学]