意义疗法对癌症患者精神、心理健康和生活质量的影响：随机对照试验的系统回顾和荟萃分析

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-04-01 DOI:10.1016/j.apjon.2024.100388

Mimi Sun , Xia Tian , Yunyi Peng, Zheng Wang, Yongmei Lu, Wenli Xiao

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引用次数: 0

摘要

本研究旨在系统回顾对癌症患者进行意义疗法的研究，并评估其对精神疗效、心理疗效和生活质量（QOL）的影响。研究方法：从开始至2023年8月，在五个国际数据库（PubMed、Embase、Web of Science、The Cochrane Library和CINAHL）和四个中文数据库（CNKI、万方数据、VIP和CBM）中进行了全面的文献检索。采用修订后的 Cochrane 随机试验偏倚风险工具对每项纳入研究的方法学质量进行评估。采用随机效应模型或固定效应模型进行效应大小分析，并计算标准化平均差（SMD）或平均差（MD）及其相应的 95% 置信区间（CI）。本综述纳入了八项随机对照试验，共有 1251 人参与。元分析表明，意义疗法可以显著改善精神成果，包括人生意义（SMD = -0.48; 95% CI = -0.89 to -0.07；P = 0.02）、无望感（SMD = -0.30; 95% CI = -0.51 to -0.09；P = 0.005）、自尊（MD = -2.74；95% CI = -4.17至-1.32；P = 0.0002）和精神幸福感（MD = -3.32；95% CI = -5.63至-1.01；P = 0.005），心理结果包括焦虑（MD = -0.66；95% CI = -1.30 至-0.01; P = 0.05）、抑郁（SMD = -0.37; 95% CI = -0.55 to -0.20; P < 0.0001）、心理困扰（SMD = -0.35; 95% CI = -0.70 to -0.01; P = 0.04）和希望加速死亡（MD = -0.76; 95% CI = -1.47 to -0.结论意义疗法对改善癌症患者的精神、心理健康和 QOL 有积极作用。我们需要更多样本量更大的高质量随机对照试验来证实我们的综述结果，并在未来明确意义疗法的长期效果。系统综述注册PROSPERO（编号：CRD42021278286）。

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Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials

Objective

This study aimed to systematically review studies of meaning therapy on patients with cancer and to evaluate its effectiveness on spiritual outcomes, psychological outcomes, and quality of life (QOL).

Methods

A comprehensive literature search were performed in five international databases (PubMed, Embase, Web of Science, The Cochrane Library, and CINAHL) and four Chinese databases (CNKI, Wanfang Data, VIP, and CBM) from the inception to August 2023. The methodological quality of each included studies was evaluated by using the revised Cochrane risk-of-bias tool for randomized trials. The random-effects model or fixed-effects model was utilized for effect size analysis, and the standardized mean difference (SMD) or mean difference (MD) along with its corresponding 95% confidence interval (CI) was computed. Meta-analysis was conducted by using the RevMan software 5.4.1.

Results

Eight randomized controlled trials with 1251 participants were included in this review. Meta-analyses revealed that meaning therapy can significantly improve the spiritual outcomes including meaning in life (SMD = −0.48; 95% CI = −0.89 to −0.07; P = 0.02), hopelessness (SMD = −0.30; 95% CI = −0.51 to −0.09; P = 0.005), self-esteem (MD = −2.74; 95% CI = −4.17 to −1.32; P = 0.0002) and spiritual well-being (MD = −3.32; 95% CI = −5.63 to −1.01; P = 0.005), psychological outcomes including anxiety (MD = −0.66; 95% CI = −1.30 to −0.01; P = 0.05), depression (SMD = −0.37; 95% CI = −0.55 to −0.20; P < 0.0001), psychological distress (SMD = −0.35; 95% CI = −0.70 to −0.01; P = 0.04) and desire for hastened death (MD = −0.76; 95% CI = −1.47 to −0.05; P = 0.04), and QOL (SMD = −0.29; 95% CI = −0.50 to −0.09; P = 0.006) in patients with cancer.

Conclusions

Meaning therapy has positive effects on improving spirituality, psychological health, and QOL of patients with cancer. More high-quality randomized controlled trials with larger sample sizes are warranted to confirm the results of our review and to clarify the long-term effects of meaning therapy in the future.