基于互联网的社会心理干预对终末期肿瘤患者主要照顾者影响的Meta分析

The effects of internet-based psychosocial interventions on primary caregivers of terminal cancer patients:a Meta-analysis

目的系统评价基于互联网的社会心理干预对终末期肿瘤患者主要照顾者的干预效果。方法系统检索中国生物医学文献数据库、中国知网、PubMed、Embase、CINAHL等10个数据库,收集基于互联网对终末期肿瘤患者主要照顾者实施社会心理干预的随机对照试验。检索时限为建库至2023年12月18日,由2名研究者按照纳入和排除标准筛选文献并提取资料,使用Cochrane手册5.1.0版评价文献质量,采用RevMan 5.4软件进行Meta分析。结果共纳入9篇文献,包括592名主要照顾者。Meta分析结果显示,实施基于互联网的社会心理干预可以减轻终末期肿瘤患者主要照顾者的焦虑抑郁水平[MD=-1.64,95%CI(-2.68,-0.59),P=0.002]及照顾负担[SMD=-0.39,95%CI(-0.60,-0.18),P<0.001],提高生活质量[SMD=0.25,95%CI(0.01,0.48),P=0.040];在减轻痛苦程度方面的干预效果不明确[MD=-0.88,95%CI(-1.91,0.16),P=0.100]。结论实施基于互联网的社会心理干预有助于改善终末期肿瘤患者主要照顾者的焦虑抑郁水平、减轻照顾负担,提高生活质量;在减轻痛苦程度方面仍需进一步研究。

Objective To evaluate the effect of Internet-based psychosocial intervention for primary caregivers of patients with terminal stage cancer.Methods The relevant randomized controlled trials of Internet-based psychosocial intervention for primary caregivers of patients with terminal stage cancer were systematically searched from 10 databases,such as Chinese Biomedical Literature Database,CNKI,PubMed,Embase and CINAHL and etc.The search period was from the establishment to December 18,2023,and 2 investigators screened the literature according to inclusion and exclusion criteria and extracted data.Cochrane Manual 5.1.0 was used to assess the quality of the literature.Meta-analysis was performed using Revman 5.4 software.Results A total of 9 pieces of the literature including 592 primary caregivers were included.Meta-analysis showed that Internet-based psychosocial intervention reduced the level of anxiety and depression for primary caregivers of patients with terminal stage cancer[MD=-1.64,95%CI(-2.68,-0.59),P=0.002]and the burden of care[SMD=-0.39,95%CI(-0.60,-0.18),P<0.001],and improved quality of life[SMD=0.25,95%CI(0.01,0.48),P=0.040];further research is needed to explore the effect of reducing the level of distress[MD=-0.88,95%CI(-1.91,0.16),P=0.100].Conclusion The Internet-based psychosocial intervention is effective in improving the anxiety,depression and the burden of care of the primary caregivers of patients with terminal stage cancer,and it can improve the quality of life;further research is needed to explore the level of distress reduction.