网络认知行为治疗对癌症患者心理痛苦、抑郁、焦虑和生活质量影响的Meta分析  

Internet-based cognitive behavioral therapy for distress, depression, anxiety and quality of life in cancer patients: a Meta-analysis

作　　者：刘一萱 郭俊伟 刘超[2] Liu Yixuan;Guo Junwei;Liu Chao(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China;School of Big Data&Software Engineering,Chongqing University,Chongqing 401331,China)

机构地区：[1]重庆市中医院,重庆400021 [2]重庆大学大数据与软件工程学院,重庆401331

出　　处：《四川精神卫生》2023年第4期326-333,共8页Sichuan Mental Health

摘　　要：背景 网络认知行为治疗(ICBT)越来越多地应用于缓解癌症患者的焦虑抑郁情绪,但目前尚无ICBT对癌症患者焦虑、抑郁、心理痛苦以及生活质量影响的荟萃分析。目的 运用系统评价的方法,探讨ICBT对缓解癌症患者心理痛苦、抑郁、焦虑症状以及提高生活质量的效果。方法 于2022年3月28日,以PubMed、PsycINFO、Embase、Cochrane Library、Web of Science、中国知网、维普、万方、中国生物医学文献数据库为数据源,系统收集关于癌症患者心理痛苦、抑郁、焦虑、生活质量、且以ICBT为治疗手段的随机对照试验(RCT)。评价纳入文献的偏倚风险后,采用Stata 17.0进行Meta分析。结果 共纳入12项RCT,包括1 686例患者。Meta分析结果显示,与对照组接受的干预措施相比,ICBT有助于缓解癌症患者的心理痛苦(SMD=-0.547,95%CI:-1.090~-0.145,P<0.01),但对抑郁(SMD=-0.652,95%CI:-1.734~0.002,P=0.051)、焦虑(SMD=-1.045,95%CI:-3.656~0.101,P=0.088)以及生活质量(SMD=0.234,95%CI:-0.064~0.449,P=0.112)的改善效果不明显。ICBT组脱落率高于对照组(OR=1.795,95%CI:1.358~2.374,P<0.01)。结论 ICBT对癌症患者的心理痛苦有一定的缓解作用,但对抑郁和焦虑症状以及生活质量的改善不明显。Background Internet-based cognitive behavioral therapy(ICBT)is progressively emerging as an efficacious alternative to alleviate anxiety and depression in cancer patients.To date,no Meta-analysis has been conducted specific to the effect of ICBT on anxiety,depression,distress and quality of life in cancer patients.Objective To assess the effect of ICBT on distress,depression,anxiety and quality of life in cancer patients through a systematic review of the literature.Methods On March 28,2022,PubMed,PsycINFO,Embase,Cochrane Library,Web of Science,CNKI,VIP,Wanfang Data and CBM were retrieved for the randomized controlled trials(RCTs)involving ICBT targeting either distress,depression,anxiety,quality of life or all in cancer patients.After the risk of bias assessment,Stata 17.0 software was used for Meta-analysis.Results A total of 12 RCTs with a total sample size of 1686 patients were included.Meta-analysis revealed that the superiority of ICBT over controls was evident for interventions targeting distress in cancer patients(SMD=-0.547,95%CI:-1.090~-0.145,P<0.01),while appeared to be less evident for the interventions targeting depression(SMD=-0.652,95%CI:-1.734~0.002,P=0.051),anxiety(SMD=-1.045,95%CI:-3.656~0.101,P=0.088)and quality of life(SMD=0.234,95%CI:-0.064~0.449,P=0.112)in cancer patients,and dropout rate was higher in ICBT group than that in control group(OR=1.795,95%CI:1.358~2.374,P<0.01).Conclusion ICBT is reported to be effective in alleviating distress in cancer patients,whereas results inconsiderable improvements over depression,anxiety and quality of life in cancer patients.

关 键 词：网络 认知行为治疗 癌症患者 META分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学]