Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: Meta-analyses
Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: Meta-analyses
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DOI：
10.2190/eufn-rv1k-y3tr-fk0l
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发表时间：
2006-01-01
影响因子：
2
通讯作者：
Feuerstein, Michael
中科院分区：
文献类型：
--
作者：
Osborn, Robyn L.;Demoncada, Angelique C.;Feuerstein, Michael
目的：本Meta分析旨在探讨认知行为疗法(CBT)和患者教育(PE)对成年癌症幸存者常见问题(抑郁、焦虑、疼痛、身体功能和生活质量)的影响。方法：对CBT和PE的随机对照试验进行Meta分析。检索了1993-2004年间的Medline、SouInfo和Cochrane数据库。个人干预与群体干预以及短期(8个月)与长期(8个月)随访的效果也被报道。结果：15项研究符合质量标准。样本大小为1,492名成年癌症幸存者，年龄范围为18-84岁。790人被随机分配到干预组，702人被分配到对照组。CBT的持续时间从每周4次1小时到55次每周2小时不等。从一次20分钟的体育锻炼到6次每周1小时的体育锻炼不等。术后随访1周至14个月。CBT对抑郁(ES=1.2；95%CI=0.22~2.19)、焦虑(ES=1.99；95%CI=0.69~3.31)和生活质量(ES=0.91；95%CI=0.38~1.44)有效。生活质量在短期和长期(ES=1.45，95%CI=0.43~2.47)和长期(ES=0.26；95%CI=0.06~0.46)均有改善。PE与改善结果无关。结论：CBT与抑郁和焦虑的短期疗效以及对生活质量的短期和长期效果有关。个体干预比集体干预更有效。以个人形式提供的各种CBT方法可以帮助癌症幸存者减少情绪困扰，提高生活质量。
Objective: The purpose of this meta-analysis was to investigate the effects of cognitive behavioral therapy (CBT) and patient education (PE) on commonly reported problems (depression, anxiety, pain, physical functioning, and quality of life (QOL)) in adult cancer survivors. Methods: Meta analyses of randomized controlled trials of CBT and PE were conducted. MEDLINE, PSYCHINFO and the Cochrane Database were searched from 1993-2004. The effects of individual versus group interventions and short (< 8 months) versus long (> 8 months) term follow up are also reported. Results: Fifteen studies met quality criteria. The sample size was 1,492 adult cancer survivors with an age range of 18-84. 790 were randomly assigned to intervention groups and 702 to control groups. CBT varied in duration from 4 weekly one-hour sessions to 55 weekly two-hour sessions. PE ranged from a single 20-minute session to 6 weekly one-hour sessions. Follow up ranged from I week to 14 months. CBT was effective for depression (ES = 1.2; 95% Cl = 0.22-2.19), anxiety (ES = 1.99; 95% Cl = 0.69-3.31), and QOL (ES = 0.91; 95% CI = 0.38-1.44). QOL was improved at both short and (ES = 1.45, 95% CI =.43-2.47) and long term (ES =.26; 95% Cl =.06-.46) follow up. PE was not related to improved outcomes. Conclusions: CBT is related to short-term effects on depression and anxiety and both short and long term effects on QOL. Individual interventions were more effective than group. Various CBT approaches provided in an individual format can assist cancer survivors in reducing emotional distress and improving quality of life.