Pre-intervention distress moderates the efficacy of psychosocial treatment for cancer patients: a meta-analysis.
Pre-intervention distress moderates the efficacy of psychosocial treatment for cancer patients: a meta-analysis.
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DOI：
10.1007/s10865-009-9227-2
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发表时间：
2010-02
影响因子：
3.1
通讯作者：
Targhetta, Valerie
中科院分区：
文献类型：
--
作者：
Schneider, Stefan;Moyer, Anne;Knapp-Oliver, Sarah;Sohl, Stephanie;Cannella, Dolores;Targhetta, Valerie
这项荟萃分析研究了心理社会干预对癌症患者心理困扰的影响是否取决于干预前的困扰水平。检索了 1980 年至 2005 年间已发表的文章和未发表的论文，寻找报告医院焦虑和抑郁量表 (HADS) 或斯皮尔伯格状态特质焦虑量表 (STAI) 的干预措施。使用多级混合效应模型分别对 HADS（27 项试验，2424 名患者）和 STAI（34 项试验，2029 名患者）的效应大小进行荟萃分析。干预前的痛苦显着调节了干预效果，解释了高达 50% 的研究间效应大小差异：当干预前的痛苦较低时，对焦虑和抑郁的影响通常可以忽略不计，而当干预前的痛苦较高时，对焦虑和抑郁的影响通常可以忽略不计。这些结果不能用干预类型、环境、剂量以及干预是否针对痛苦患者的差异来解释。心理社会干预可能对痛苦加剧的癌症患者最有益。未来的研究应该确定哪些治疗成分对这些患者最有效，以促进最佳的治疗定制和具有成本效益的医疗保健。
This meta-analysis examined whether effects of psychosocial interventions on psychological distress in cancer patients are conditional upon pre-intervention distress levels. Published articles and unpublished dissertations between 1980 and 2005 were searched for interventions reporting the Hospital Anxiety and Depression Scale (HADS) or the Spielberger State-Trait Anxiety Inventory (STAI). Multilevel mixed-effects modeling was used to meta-analyze effect-sizes separately for the HADS (27 trials, 2424 patients) and STAI (34 trials, 2029 patients). Pre-intervention distress significantly moderated intervention effects, explaining up to 50% of the between-study effect-size variance: effects on anxiety and depression were generally negligible when pre-intervention distress was low and pronounced when it was high. These results could not be explained by differences in intervention type, setting, dose, and whether intervention was targeted at distressed patients. Psychosocial interventions may be most beneficial for cancer patients with elevated distress. Future research should identify which treatment components are most effective for these patients to facilitate optimal treatment tailoring and cost-effective health care.
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影响因子：
3.1
作者：
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通讯作者：
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影响因子：
5.9
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影响因子：
6.2
作者：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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