第三波认知行为干预对晚期癌症患者生物心理社会结局的影响：随机对照试验的系统回顾和荟萃分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-03-18 DOI:10.1016/j.jpsychores.2025.112106

Elizabeth Beasley , Victoria White , Anna Ugalde , Joanne Brooker , David Skvarc , Antonina Mikocka-Walus

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引用次数: 0

摘要

目的晚期癌症患者心理发病率升高，生活质量下降。第三波认知行为疗法（CBT）干预在解决这些需求方面的作用已经得到了检验，但没有在系统综述中综合。本综述的目的是系统地识别、分析和回顾随机对照试验（rct），这些试验检验了第三波CBT干预对该人群的生物心理社会结局（如焦虑、疼痛、生活质量）的影响。方法系统检索MEDLINE、PsycInfo、CINAHL、Embase和Cochrane CENTRAL。在随机对照试验中，如果研究检查了第三波CBT干预对晚期癌症成人的生物心理社会结果的影响，则纳入研究。Cochrane偏倚风险工具评估了每项研究的偏倚风险。对数据拟合随机效应模型，并应用限制性最大似然估计。采用对照组与试验组在短期和长期随访时的标准化平均差异（SMD）。结果共纳入12项随机对照试验，共纳入受试者782人。meta分析显示，第三波CBT干预仅在短期改善生活质量方面比比较组更有效(SMD = 0.19, 95% CI [0.00, 0.37], p <；0.05)。其他11项荟萃分析的结果没有达到统计学意义。8项研究被归类为风险不明确，4项研究被归类为高风险偏倚。结论第三波CBT干预可有效提高晚期癌症患者的生活质量。然而，需要更严格的随机对照试验来确定其在该人群中的有效性。

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Effect of third-wave cognitive behavioural interventions on biopsychosocial outcomes in people diagnosed with advanced cancer: A systematic review and meta-analysis of randomised controlled trials

Objective

People with advanced cancer experience elevated psychological morbidity and poor quality of life (QoL). The role of third-wave cognitive-behavioural therapy (CBT) interventions in addressing these needs has been examined, but not synthesised in a systematic review. The aim of this review is to systematically identify, analyse and review randomised controlled trials (RCTs) which examined the effect of third-wave CBT interventions on biopsychosocial outcomes (e.g., anxiety, pain, QoL) in this population.

Methods

A systematic search was undertaken on MEDLINE, PsycInfo, CINAHL, Embase and Cochrane CENTRAL. Studies were included if they examined the effect of third-wave CBT interventions on biopsychosocial outcomes in adults living with advanced cancer in RCTs. The Cochrane Risk of Bias tool assessed risk of bias for each study. A random-effects model was fitted to the data and the restricted maximum-likelihood estimator was applied. The standardised mean differences (SMD) between control and experimental groups at short- and long-term follow up were used.

Results

Twelve RCTs with 782 participants were identified. Meta-analyses demonstrated that third-wave CBT interventions were only more effective than comparator groups in the short-term improvement of QoL (SMD = 0.19, 95 % CI [0.00, 0.37], p < 0.05). The results of the 11 other meta-analyses did not reach statistical significance. Eight studies were classified as having unclear risk, and four were classified as high risk of bias.

Conclusions

Third-wave CBT interventions may be effective in enhancing QoL in people with advanced cancer. However, more rigorous RCTs are needed to establish their efficacy in this population.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.