不同心理干预对癌症患者复发恐惧影响效果的网状Meta分析

The efficacy of different types of psychological interventions on the fear of cancer recurrence:a network Meta-analysis

目的通过网状Meta分析评价不同心理干预措施对癌症患者复发恐惧的影响效果。方法检索PubMed、PsycINFO、Web of Science、The Cochrane Library、Embase、EBSCO、中国生物医学文献服务系统、中国知网、万方数据库及维普数据库中关于不同心理干预对癌症复发恐惧效果的随机对照试验,检索时限为建库至2022年12月31日。对纳入文献进行筛选、提取资料及质量评价,采用Stata14.0软件进行网状Meta分析。结果纳入29项随机对照研究,11种心理干预措施,共3068例癌症患者。网状Meta分析显示,与常规护理相比,叙事疗法、PERMA(P:积极的情绪;E:投入;R:人际关系;M:意义;A:成就)幸福理论模式、接纳承诺疗法、认知行为疗法对癌症复发恐惧的干预效果差异均有统计学意义(SMD值为-1.93~-0.83,均P<0.05),叙事疗法与PERMA幸福理论模式、接纳承诺疗法和感恩拓展行为理论干预效果比较差异均无统计学意义(均P>0.05)。排序概率图显示叙事疗法的干预效果最佳。结论叙事疗法、接纳承诺疗法、认知行为疗法可能是改善癌症复发恐惧较为有效的心理干预措施,但仍需更多的研究进一步验证。

Objective To evaluate the effects of different types of psychological interventions on the fear of cancer recurrence through a network Meta-analysis.Methods Randomized controlled trials on the effects of different types of psychological interventions on the fear of cancer recurrence were retrieved from PubMed,PsycINFO,Web of Science,The Cochrane Library,Embase,EBSCO,China Biomedical Literature Database,CNKI,Wanfang Database and Vip Database.The retrieval period was from the establishment of the database to December,312022.Two researchers conducted literature screening,extraction and quality evaluation,and used Stata14.0 software to conduct network Meta-analysis.Results A total of 29 pieces of research involving 3068 cancer patients and 11 psychological intervention measures.The results of network Meta-analysis showed that narrative therapy,PERMA(Positive,Engagement,Relationship,Meaning,Accomplishment)happiness theory model,acceptance and commitment therapy and cognitive behavior therapy had statistically significant differences in the intervention effect on the fear of cancer recurrence compared with conventional nursing(SMD values were-1.93--0.83,all P<0.05);there was no significant difference among narrative therapy,PERMA happiness model,acceptance and commitment therapy and gratitude-expansion behavior theory(all P>0.05).The results of the cumulative probability map showed the best intervention was narrative therapy.Conclusions The results of this study suggest that narrative therapy,acceptance and commitment therapy,and cognitive behavior therapy may be effective psychological intervention measures to improve the fear of cancer recurrence.However,more studies are still needed for further verification.