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数字心理社会干预对妇科癌症患者心理困扰、抑郁、焦虑和健康相关生活质量的影响:系统评价和荟萃分析。

The effectiveness of digital psychosocial interventions on psychological distress, depression, anxiety, and health-related quality of life in patients with gynaecological cancer: a systematic review and meta-analysis.

机构信息

Khoo Teck Puat Hospital, Yishun Health, National Healthcare Group, Singapore, Singapore.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore.

出版信息

Support Care Cancer. 2024 Mar 21;32(4):240. doi: 10.1007/s00520-024-08415-4.

Abstract

PURPOSE

Patients with gynaecological cancer often experience psychological issues due to multiple stressors. Psychological disturbances have debilitating effects on patients with gynaecological cancer. In recent decades, digital psychosocial interventions have rapidly advanced and been incorporated into mental health interventions. Digital psychosocial interventions could provide patients with several benefits over traditional in-person interventions, including convenience, anonymity, flexible scheduling, and geographic mobility. The aim of this systematic review was to synthesize the effectiveness of digital psychosocial intervention in reducing psychological distress, depression, and anxiety and improving health-related quality of life in patients with gynaecological cancer.

METHODS

Three-step extensive search was performed on 22 December 2022 from nine bibliographic databases, trial registries and grey literature. Experimental studies involving patients with gynaecological cancer utilizing digital psychosocial interventions for the improvement of mental health outcomes were included. Meta-analysis was conducted using RevMan 5.4 software. Heterogeneity was analysed by Cochran's Q test and I. Subgroup analyses were attempted to evaluate relative effect sizes of subgroup features.

RESULTS

Meta-analysis of nine studies revealed small effect size in reduction of depression post-intervention (d = 0.24, 95% CI - 0.46 to - 0.02) and medium effect size in reduction of psychological distress post-intervention (d = 0.51, 95% CI - 0.81 to - 0.21) and follow-up (d = 0.65, 95% CI - 1.25 to - 0.05) compared to the control group. The effects of digital psychosocial interventions on anxiety and health-related quality of life were not statistically significant.

CONCLUSIONS

Digital psychosocial interventions probably reduced psychological distress and slightly reduced depression amongst patients with gynaecological cancer compared to the control group, which can be integrated into clinical practice. Additional trials with rigorous methodology and bigger sample sizes are needed to validate findings.

TRIAL REGISTRATION

PROSPERO (CRD42023389502).

摘要

目的

妇科癌症患者由于多种应激源经常会出现心理问题。心理障碍对妇科癌症患者有很大的影响。近几十年来,数字心理社会干预迅速发展并纳入精神卫生干预措施。与传统的面对面干预相比,数字心理社会干预可能为患者提供多种益处,包括方便、匿名、灵活的时间安排和地理移动性。本系统评价的目的是综合数字心理社会干预对减轻妇科癌症患者心理困扰、抑郁和焦虑以及改善与健康相关的生活质量的效果。

方法

于 2022 年 12 月 22 日对九个文献数据库、试验注册处和灰色文献进行了三步广泛搜索。纳入了涉及使用数字心理社会干预措施改善心理健康结果的妇科癌症患者的实验研究。使用 RevMan 5.4 软件进行荟萃分析。使用 Cochran's Q 检验和 I 检验分析异质性。尝试进行亚组分析,以评估亚组特征的相对效应大小。

结果

对九项研究的荟萃分析显示,干预后抑郁程度降低的效应量较小(d=0.24,95%CI-0.46 至-0.02),干预后和随访时心理困扰程度降低的效应量中等(d=0.51,95%CI-0.81 至-0.21)。与对照组相比,数字心理社会干预对焦虑和与健康相关的生活质量没有统计学上的显著影响。

结论

与对照组相比,数字心理社会干预可能会减轻妇科癌症患者的心理困扰,并且略微减轻抑郁,但需要更多具有严格方法和更大样本量的试验来验证这些发现。

试验注册

PROSPERO(CRD42023389502)。

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