Abstract：
Older adults make up half of those with cancer and are prone to mood disorders, such as depression and severe anxiety, resulting in negative repercussions on their health-related quality-of-life (HRQOL). Educational interventions have been shown to reduce adverse psychological outcomes. We examined the effect of educational interventions on the severity of psychological outcomes in older adults with cancer (OAC) in the community.
This PRISMA-adherent systematic review involved a search of PubMed, MedLine, Embase and PsycINFO for randomised controlled trials (RCTs) that evaluated educational interventions impacting the severity of depression, anxiety and HRQOL in OAC. Random effects meta-analyses and meta-regressions were used for the primary analysis.
Fifteen RCTs were included. Meta-analyses showed a statistically insignificant decrease in the severity of depression (SMD = -0.30, 95%CI: -0.69; 0.09), anxiety (SMD = -0.30, 95%CI: -0.73; 0.13) and improvement in overall HRQOL scores (SMD = 0.44, 95%CI: -0.16; 1.04). However, subgroup analyses revealed that these interventions were particularly effective in reducing the severity of depression and anxiety in specific groups, such as OAC aged 60-65, those with early-stage cancer, those with lung cancer and those treated with chemotherapy. A systematic review found that having attained a higher education and income level increased the efficacy of interventions in decreasing the severity of adverse psychological outcomes.
Although overall meta-analyses were statistically insignificant, subgroup meta-analyses highlighted a few specific subgroups that the educational interventions were effective for. Future interventions can be implemented to target these vulnerable groups.
This PRISMA-adherent systematic review involved a search of PubMed, MedLine, Embase and PsycINFO for randomised controlled trials (RCTs) that evaluated educational interventions impacting the severity of depression, anxiety and HRQOL in OAC. Random effects meta-analyses and meta-regressions were used for the primary analysis.
Fifteen RCTs were included. Meta-analyses showed a statistically insignificant decrease in the severity of depression (SMD = -0.30, 95%CI: -0.69; 0.09), anxiety (SMD = -0.30, 95%CI: -0.73; 0.13) and improvement in overall HRQOL scores (SMD = 0.44, 95%CI: -0.16; 1.04). However, subgroup analyses revealed that these interventions were particularly effective in reducing the severity of depression and anxiety in specific groups, such as OAC aged 60-65, those with early-stage cancer, those with lung cancer and those treated with chemotherapy. A systematic review found that having attained a higher education and income level increased the efficacy of interventions in decreasing the severity of adverse psychological outcomes.
Although overall meta-analyses were statistically insignificant, subgroup meta-analyses highlighted a few specific subgroups that the educational interventions were effective for. Future interventions can be implemented to target these vulnerable groups.
摘要：
背景：老年人占癌症患者的一半，容易出现情绪障碍，比如抑郁和严重的焦虑，对他们的健康相关生活质量(HRQOL)产生负面影响。教育干预已被证明可以减少不良的心理后果。我们研究了教育干预对社区中老年癌症患者（OAC）心理结局严重程度的影响。
方法：这篇PRISMA坚持的系统综述涉及对PubMed的搜索，MedLine,Embase和PsycINFO用于随机对照试验（RCT），评估影响抑郁症严重程度的教育干预措施，OAC的焦虑和HRQOL。随机效应荟萃分析和荟萃回归用于主要分析。
结果：纳入15个随机对照试验。荟萃分析显示，抑郁症的严重程度在统计学上无统计学意义的降低（SMD=-0.30，95CI：-0.69;0.09），焦虑（SMD=-0.30，95CI：-0.73;0.13）和整体HRQOL评分的改善（SMD=0.44，95CI：-0.16;1.04）。然而,亚组分析显示，这些干预措施在降低特定人群的抑郁和焦虑严重程度方面特别有效，例如60-65岁的OAC，患有早期癌症的人，那些患有肺癌和接受化疗的人。一项系统评价发现，获得更高的教育和收入水平可以提高干预措施在降低不良心理后果严重程度方面的功效。
结论：尽管总体荟萃分析在统计学上无统计学意义，亚组荟萃分析强调了教育干预对其有效的几个特定亚组.可以针对这些弱势群体实施未来的干预措施。
方法：这篇PRISMA坚持的系统综述涉及对PubMed的搜索，MedLine,Embase和PsycINFO用于随机对照试验（RCT），评估影响抑郁症严重程度的教育干预措施，OAC的焦虑和HRQOL。随机效应荟萃分析和荟萃回归用于主要分析。
结果：纳入15个随机对照试验。荟萃分析显示，抑郁症的严重程度在统计学上无统计学意义的降低（SMD=-0.30，95CI：-0.69;0.09），焦虑（SMD=-0.30，95CI：-0.73;0.13）和整体HRQOL评分的改善（SMD=0.44，95CI：-0.16;1.04）。然而,亚组分析显示，这些干预措施在降低特定人群的抑郁和焦虑严重程度方面特别有效，例如60-65岁的OAC，患有早期癌症的人，那些患有肺癌和接受化疗的人。一项系统评价发现，获得更高的教育和收入水平可以提高干预措施在降低不良心理后果严重程度方面的功效。
结论：尽管总体荟萃分析在统计学上无统计学意义，亚组荟萃分析强调了教育干预对其有效的几个特定亚组.可以针对这些弱势群体实施未来的干预措施。
