认知行为疗法对结直肠癌病人干预效果的Meta分析

Intervention effect of cognitive behavioral therapy on patients with colorectal cancer:a Meta-analysis

目的:系统评价认知行为疗法对结直肠癌病人负性情绪和生活质量的影响。方法:检索PubMed、EMbase、Web of Science、Scopus、the Cochrane Library、中国知网、万方数据库、维普数据库中关于认知行为疗法对结直肠癌病人负性情绪和生活质量影响的随机对照试验,检索时限均从建库至2021年8月8日。由2名研究者独立筛选文献、提取资料并使用Cochrane偏倚风险评估工具评价纳入的文献后,采用RevMan 5.3软件进行Meta分析。结果:共纳入13项研究,Meta分析结果显示:认知行为疗法可缓解结直肠癌病人焦虑[SMD=-0.79,95%CI(-1.18,-0.39),P=0.0001]、抑郁[SMD=-0.78,95%CI(-1.17,-0.38),P=0.0001],提高病人自我护理能力[WMD=17.03,95%CI(6.53,27.54),P=0.001]、自我效能[SMD=0.87,95%CI(0.36,1.38),P=0.0008]及生活质量[SMD=0.89,95%CI(0.02,1.77),P<0.05]。结论:现有证据表明,认知行为疗法能够降低结直肠癌病人的焦虑、抑郁,改善病人的自我护理能力、自我效能感以及生活质量。

Objective:To systematically evaluate the influence of cognitive behavioral therapy on negative emotion and quality of life in patients with colorectal cancer.Methods:Randomized controlled trials on the influence of cognitive behavioral therapy on negative emotion and quality of life of patients with colorectal cancer were searched from PubMed,EMbase,Web of Science,Scopus,the Cochrane Library,CNKI,WanFang Database and VIP.The retrieval time was from inception to August 8,2021.After two researchers independently screened the literature,extracted the data,and evaluated the included literature with Cochrane bias risk assessment tool,RevMan 5.3 software was used for Meta-analysis.Results:A total of 13 studies were included.Meta-analysis results showed that cognitive behavioral therapy could alleviate anxiety[SMD=-0.79,95%CI(-1.18,-0.39),P=0.0001],depression[SMD=-0.78,95%CI(-1.17,-0.38),P=0.0001],improve patients′self-care ability[WMD=17.03,95%CI(6.53,27.54),P=0.001],self-efficacy[SMD=0.87,95%CI(0.36,1.38),P=0.0008],and quality of life[SMD=0.89,95%CI(0.02,1.77),P<0.05].Conclusions:Current evidence shows that cognitive behavioral therapy can reduce the anxiety and depression of patients with colorectal cancer,and improve their self-care ability,self-efficacy,and quality of life.