背景:肺癌是最常见的癌症之一,对患者的身体和心理构成威胁。基于正念的干预是一种新兴的心理治疗形式,可以有效改善身体和心理症状,但是没有评论总结它们对焦虑的有效性,抑郁症,肺癌患者的疲劳。
目的:评估基于正念的干预措施在减少焦虑方面的有效性,抑郁症,肺癌患者的疲劳。
方法:系统评价和荟萃分析。
方法:我们搜索了PubMed,WebofScience,Embase,中国生物医药光盘,万方数据,中国国家知识基础设施,和中国科技期刊数据库从成立到2022年4月13日。符合条件的研究包括肺癌患者接受基于正念的干预措施的随机对照试验,报告焦虑的结果。抑郁症,和疲劳。两名研究人员独立审查了摘要和全文,提取数据并使用Cochrane“偏倚风险评估工具”独立评估偏倚风险。使用ReviewManager5.4进行荟萃分析,并通过标准化平均差及其95%置信区间计算效应大小。
结果:系统评价包括25项研究(2420名参与者),而荟萃分析包括18项研究(1731名参与者).基于正念的干预措施显着降低了焦虑水平[标准化平均差=-1.15,95%置信区间(-1.36,-0.94),Z=10.75,P<0.001],抑郁[标准化平均差=-1.04,95%置信区间(-1.60,-0.48),Z=3.66,P<0.001],和疲劳[标准化平均差=-1.29,95%置信区间(-1.66,-0.91),Z=6.79,P<0.001]。亚组分析表明,具有结构化干预成分的计划持续时间少于八周(例如,基于正念的减压和基于正念的认知疗法)和在晚期肺癌患者中实施45分钟的每日家庭实践比持续超过8周的计划效果更好,其中结构成分较少,在混合期肺癌患者中实施超过45分钟的每日家庭实践。在大多数研究中,由于缺乏分配隐蔽性和致盲性以及偏倚的高风险(80%),证据的总体质量较低。
结论:基于正念的干预措施可能有效减少焦虑,抑郁症,肺癌患者的疲劳。然而,我们无法得出明确的结论,因为证据的整体质量较低.需要更严格的研究来确认有效性,并检查哪些干预成分可能对改善结果最有效。
BACKGROUND: Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of psychotherapy that are effective in improving physical and psychological symptoms, but no
review has summarized their effectiveness on anxiety, depression, and fatigue in people with lung cancer.
OBJECTIVE: To evaluate the effectiveness of mindfulness-based interventions in reducing anxiety, depression, and fatigue in people with lung cancer.
METHODS: Systematic
review and meta-analysis.
METHODS: We searched the PubMed, Web of Science, Embase, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, and China Science and Technology Journal databases from inception to 13 April 2022. Eligible studies included randomized controlled trials of people with lung cancer receiving mindfulness-based interventions reporting on the outcomes of anxiety, depression, and fatigue. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane \'Risk of bias assessment tool\'. The meta-analysis was performed by using
Review Manager 5.4, and the effect size was calculated by the standardized mean difference and its 95% confidence interval.
RESULTS: The systematic
review included 25 studies (2420 participants), whereas the meta-analysis included 18 studies (1731 participants). Mindfulness-based interventions significantly decreased levels of anxiety [standardized mean difference = -1.15, 95% confidence interval (-1.36, -0.94), Z = 10.75, P < 0.001], depression [standardized mean difference = -1.04, 95% confidence interval (-1.60, -0.48), Z = 3.66, P < 0.001], and fatigue [standardized mean difference = -1.29, 95% confidence interval (-1.66, -0.91), Z = 6.79, P < 0.001]. The subgroup analysis indicated that programs lasting less than eight weeks in length with structured intervention components (e.g., mindfulness-based stress reduction and mindfulness-based cognitive therapy) and 45 min of daily home practice implemented in patients with advanced stage lung cancer showed better effects than programs lasting more than eight weeks in length with less structured components and more than 45 min of daily home practice implemented in patients with mixed stage lung cancer. The overall quality of the evidence was low due to the lack of allocation concealment and blinding and the high risk of bias in most studies (80%).
CONCLUSIONS: Mindfulness-based interventions might be effective in reducing anxiety, depression, and fatigue in people with lung cancer. However, we cannot draw definitive conclusions because the overall quality of the evidence was low. More rigorous studies are needed to confirm the effectiveness and examine which intervention components may be most effective for improved outcomes.