Tao Zhang , Zhihong Ren , Claire Elizabeth Wakefield , Bryant Pui Hung Hui , Tatsuo Akechi , Congrong Shi , Xiayu Du , Wenke Chen , Lizu Lai , Chunxiao Zhao , Ying Li , Yubu Zhou
{"title":"数字心理干预对癌症患者的心理困扰和生活质量是否有效？系统回顾和网络荟萃分析","authors":"Tao Zhang , Zhihong Ren , Claire Elizabeth Wakefield , Bryant Pui Hung Hui , Tatsuo Akechi , Congrong Shi , Xiayu Du , Wenke Chen , Lizu Lai , Chunxiao Zhao , Ying Li , Yubu Zhou","doi":"10.1016/j.cpr.2024.102520","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Many cancer patients experience psychological distress and/or poor quality of life during or after their cancer treatment, yet they face multiple barriers to accessing psychological support. Digital psychological interventions represent a promising approach for addressing these barriers, however their comparative effectiveness remains uncertain.</div></div><div><h3>Methods</h3><div>Nine databases were searched for randomized controlled trials (RCTs) from inception to July 2024. The primary outcomes were psychological distress and quality of life, and the secondary outcomes were measures of depression, anxiety, insomnia, fatigue, and fear of cancer recurrence in this study.</div></div><div><h3>Results</h3><div>One hundred and thirty-six RCTs with 23,154 participants were identified. Of these interventions, three types—digitally-delivered cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT)—demonstrated significant reductions in psychological distress compared to non-active controls. Digital CBT, narrative interventions, and VRT significantly improved quality of life compared to non-active controls. For depression, both digital CBT and VRT were superior to the non-active control group. Regarding anxiety, CBT, psychoeducation, and VRT outperformed the non-active control group. In terms of fatigue, CBT, psychoeducation, VRT, and multi-component interventions all showed enhanced efficacy compared to the non-active control group. However, only CBT exhibited significantly superior effectiveness in alleviating insomnia compared to non-active controls. Similarly, only mindfulness-based interventions significantly reduced fear of cancer recurrence compared to the non-active control condition.</div></div><div><h3>Conclusions</h3><div>Our results suggest that digital CBT and VRT are highly promising options for reducing psychological distress and enhancing the quality of life among cancer patients; further high-quality randomized controlled trials involving diverse populations are essential to validate these findings.</div></div>","PeriodicalId":48458,"journal":{"name":"Clinical Psychology Review","volume":"115 ","pages":"Article 102520"},"PeriodicalIF":13.7000,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Are digital psychological interventions for psychological distress and quality of life in cancer patients effective? 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The primary outcomes were psychological distress and quality of life, and the secondary outcomes were measures of depression, anxiety, insomnia, fatigue, and fear of cancer recurrence in this study.</div></div><div><h3>Results</h3><div>One hundred and thirty-six RCTs with 23,154 participants were identified. Of these interventions, three types—digitally-delivered cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT)—demonstrated significant reductions in psychological distress compared to non-active controls. Digital CBT, narrative interventions, and VRT significantly improved quality of life compared to non-active controls. For depression, both digital CBT and VRT were superior to the non-active control group. Regarding anxiety, CBT, psychoeducation, and VRT outperformed the non-active control group. In terms of fatigue, CBT, psychoeducation, VRT, and multi-component interventions all showed enhanced efficacy compared to the non-active control group. 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Are digital psychological interventions for psychological distress and quality of life in cancer patients effective? A systematic review and network meta-analysis
Background
Many cancer patients experience psychological distress and/or poor quality of life during or after their cancer treatment, yet they face multiple barriers to accessing psychological support. Digital psychological interventions represent a promising approach for addressing these barriers, however their comparative effectiveness remains uncertain.
Methods
Nine databases were searched for randomized controlled trials (RCTs) from inception to July 2024. The primary outcomes were psychological distress and quality of life, and the secondary outcomes were measures of depression, anxiety, insomnia, fatigue, and fear of cancer recurrence in this study.
Results
One hundred and thirty-six RCTs with 23,154 participants were identified. Of these interventions, three types—digitally-delivered cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT)—demonstrated significant reductions in psychological distress compared to non-active controls. Digital CBT, narrative interventions, and VRT significantly improved quality of life compared to non-active controls. For depression, both digital CBT and VRT were superior to the non-active control group. Regarding anxiety, CBT, psychoeducation, and VRT outperformed the non-active control group. In terms of fatigue, CBT, psychoeducation, VRT, and multi-component interventions all showed enhanced efficacy compared to the non-active control group. However, only CBT exhibited significantly superior effectiveness in alleviating insomnia compared to non-active controls. Similarly, only mindfulness-based interventions significantly reduced fear of cancer recurrence compared to the non-active control condition.
Conclusions
Our results suggest that digital CBT and VRT are highly promising options for reducing psychological distress and enhancing the quality of life among cancer patients; further high-quality randomized controlled trials involving diverse populations are essential to validate these findings.
期刊介绍：
Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology.
While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.
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