"Having a Why to Live Can Bear Almost Any How"-Meaning-focused Interventions on Cancer-related Clinical Symptoms: Systematic Review and Meta-Analysis.

IF 3.5 2区 医学 Q2 CLINICAL NEUROLOGY
Ki Sum Samson Wong, Mu-Hsing Ho, Tianxue Hou, Chia-Chin Lin
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引用次数: 0

Abstract

Context: According to Dr Viktor Frankl's existential framework, distress in patients' spiritual dimensions could manifest as symptoms in both physical/biological and the psychological dimensions. Meaning-focused interventions (MFI) refer to the subset of spiritual care/existential interventions designed to prominently address cancer patients' loss of meaning in life.

Objectives: To evaluate the effects of MFI on cancer-related physical and psychological symptoms.

Methods: Search was conducted across 10 databases from inception to October 8, 2024. Primary outcomes included a list of symptoms previously reported as prevalent among cancer patients. Secondary outcome was symptom distress.

Results: 23 RCTs and three quasi-experimental studies, involving 2889 patients, were included. Significant effects were found on Fatigue (SMD, -2.48; 95% CI, -3.95 to -1.00; k = 6), Pain Intensity (SMD, -0.42; 95% CI, -0.74 to -0.09; k = 2), Insomnia (SMD, -0.74; 95% CI, -1.44 to -0.04; k = 4), Depressive Symptoms (SMD, -0.39; 95% CI, -0.61 to -0.18; k = 17), Anxiety (SMD, -0.51; 95% CI, -0.78 to -0.25; k = 15), Cognitive Function (MD, 1.65; 95% CI, 1.00 to 2.31; k = 2), Retrospective Memory (MD, -2.90; 95% CI, -5.35 to -0.46; k = 2) and Prospective Memory (MD, -2.22; 95% CI, -3.71 to -0.74; k = 2). Non-significant effects were found on Appetite Loss, Symptom Distress.

Conclusion: Our meta-analysis could inform future integration of spiritual care into routine medical care for cancer patients. Meanwhile, findings on cognitive function and memory were based on poor-quality studies and hence should be interpreted with caution. Healthcare providers might consider (i) infusing a meaning-in-life component into physical exercise intervention for cancer patients to reduce dropout, (ii) exploring Low-intensity MFI as a cost-saving option for providing spiritual care. Future research should also work towards equitable access to MFI for brain cancer patients.

“知道为什么要活,几乎可以承受任何如何活”——对癌症相关临床症状的意义干预:系统回顾和荟萃分析。
背景:根据维克多·弗兰克尔博士的存在主义框架,患者精神层面的痛苦可以表现为生理/生物和心理层面的症状。以意义为中心的干预(MFI)是指精神护理/存在主义干预的一个子集,旨在突出解决癌症患者生活意义的丧失。目的:评价MFI对肿瘤相关生理和心理症状的影响。方法:检索自成立至2024年10月8日的10个数据库。主要结果包括先前报道的癌症患者普遍存在的一系列症状。次要结局为症状窘迫。结果:共纳入23项随机对照试验和3项准实验研究,共2889例患者。显著的影响被发现在疲劳(SMD, -2.48; 95%置信区间,-3.95至-1.00;k = 6),疼痛强度(SMD, -0.42; 95%置信区间,-0.74至-0.09;k = 2),失眠(SMD, -0.74; 95%置信区间,-1.44至-0.04;k = 4),抑郁症状(SMD, -0.39; 95%置信区间,-0.61至-0.18;k = 17),焦虑(SMD, -0.51; 95%置信区间,-0.78至-0.25;k = 15),认知功能(医学博士,1.65;95%置信区间,1.00至2.31;k = 2),回顾记忆(医学博士,-2.90;95%置信区间,-5.35至-0.46;k = 2)和前瞻记忆(医学博士,-2.22;95% CI, -3.71 ~ -0.74;k = 2)。对食欲减退、症状困扰无显著影响。结论:我们的荟萃分析可以为未来将精神护理纳入癌症患者的常规医疗护理提供信息。同时,关于认知功能和记忆的发现是基于低质量的研究,因此应该谨慎解释。医疗保健提供者可以考虑(i)在癌症患者的体育锻炼干预中注入生命意义的成分,以减少辍学,(ii)探索低强度MFI作为提供精神护理的一种节省成本的选择。
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来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
期刊介绍: The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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