心理干预对癌症患者病耻感影响的meta分析

Meta analysis of effect of psychological intervention on stigma sense in cancer patients

目的系统评价心理干预对癌症患者病耻感的影响。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL Complete、中国知网(CNKI)、万方医学网、维普资讯中文期刊服务平台(VIP)、中国生物医学文献服务系统(CBM)建库至2021年5月关于心理干预癌症患者病耻感的随机对照试验(RCT),采用Revman5.3软件进行meta分析。结果共纳入14项RCT,涉及癌症患者2002例。心理干预可明显降低癌症患者病耻感水平,差异有统计学意义[加权均数差(WMD)=-8.39,95%可信区间(95%CI):-10.59~-6.20,P<0.05]。短期干预、长期干预均可明显改善癌症患者病耻感,差异均有统计学意义(MD=-7.95、-7.17,95%CI:-9.56~-6.35、11.68~-2.65,P<0.05)。个体干预、团体干预后患者病耻感总体水平均明显下降,差异均有统计学意义(MD=-7.74、-7.42,95%CI:-10.53~-4.95、-11.02~-3.82,P<0.05)。电话干预、面对面交谈均可使患者病耻感减弱,差异均有统计学意义(MD=-7.80、-8.18,95%CI:-11.93~-3.66、-10.28~-6.08,P<0.05)。结论心理干预能降低癌症患者病耻感,短期、个体及面对面干预更加有效。

Objective To systematically evaluate the influence of psychological intervention on stigma sense of cancer patients.Methods The randomized controlled trials(RCT)on the psychological intervention of stigma sense in cancer patients published in the databases of PubMed,Web of Science,Cochrane Library,Embase,CINAHL Complete,CNKI,Wanfang,VIP,and CBM database were retrieved by computer from their establishment to June 2021.The meta analysis was performed by using the Revman 5.3 software.Results A total of 14 RCT were included,involving 2002 cases of cancer.The psychological intervention could significantly reduce the level of stigma sense in cancer patients,and the difference was statistically significant(WMD=-8.39,95%CI:-10.59--6.20,P<0.01).The short-term intervention(MD=-7.95,95%CI:-9.56--6.35,P<0.01)and long-term intervention(MD=-7.17,95%CI:11.68,-2.65,P<0.05)could improve the stigma sense of cancer patients,and the differences were statistically significant.After the individual intervention(MD=-7.74,95%CI:-10.53--4.95,P<0.01)and group intervention(MD=-7.42,95%CI:-10.53--4.95,P<0.01),the overall level of stigma sense was significantly decreased,and the difference was statistically significant(MD=-7.74,-7.42,95%CI:-10.53--4.95,-11.02--3.82,P<0.05).The telephone intervention(MD=-7.80,95%CI:-11.93,-3.66,P<0.01)and face-to-face conversation(MD=-8.18,95%CI:-10.28,-6.08,P<0.01)could weaken the stigma sense of the patients,and the difference was statistically significant(P<0.05).Conclusion The psychological intervention can reduce the stigma sense of cancer patients,short-term,individual and face-to-face intervention are more effective.