Made Satya Nugraha Gautama, Tsai-Wei Huang, Haryani Haryani, Gaviota Khalish, An-I Liu, Yan Adi Wibawa
{"title":"管理癌症和有意义地生活（CALM）治疗提高癌症患者的生活质量：随机对照试验的荟萃分析。","authors":"Made Satya Nugraha Gautama, Tsai-Wei Huang, Haryani Haryani, Gaviota Khalish, An-I Liu, Yan Adi Wibawa","doi":"10.1111/jocn.17754","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cancer patients, at both early and advanced stages, face complex bio-psycho-social-spiritual problems impacting their quality of life (QoL). Managing Cancer and Living Meaningfully (CALM) therapy is a psychotherapeutic approach that helps cancer patients find hope and meaning in life, thereby improving QoL.</p><p><strong>Aim: </strong>This study aimed to critically assess the effects of CALM therapy on the QoL in cancer patients.</p><p><strong>Design: </strong>This was a systematic review and meta-analysis of randomised controlled trials (RCTs).</p><p><strong>Methods: </strong>The main outcome was QoL, and the secondary outcomes were anxiety, depression, spiritual well-being, fatigue and sleep quality. Five English databases (PubMed, Embase, Scopus, Cochrane Library and ProQuest) and one trial registry site (Clinicaltrial.gov) were searched from their inception until March 2024. The pooled effect sizes were calculated using random-effects models and expressed as standard mean difference (SMD) or weighted mean difference (WMD). Review Manager 5.4 was used for data analysis. A sensitivity analysis was done by excluding one trial at a time to check the consistency of the results on QoL. The study protocol was prospectively registered on PROSPERO (CRD42023398655).</p><p><strong>Results: </strong>Fifteen trials met the inclusion criteria for the systematic review and twelve for the meta-analysis, with a total of 1635 cancer patients. CALM therapy showed significant benefits on QoL (SMD = 1.97), spiritual well-being (WMD = 1.93) and sleep quality (SMD = -1.56) compared with usual care. It also reduced anxiety (SMD = -1.94), depression (SMD = -1.28) and fatigue (SMD = -5.86) significantly. The sensitivity analysis confirmed the stability of these results when each trial was removed one by one.</p><p><strong>Conclusion: </strong>CALM therapy may improve QoL, spiritual well-being, sleep quality and relieve anxiety, depression and fatigue in cancer patients.</p><p><strong>Relevance to clinical practice: </strong>This therapy should be promoted clinically as a comprehensive psychotherapeutic approach in cancer care.</p><p><strong>Registration: </strong>CRD42023398655.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Managing Cancer and Living Meaningfully (CALM) Therapy for Improving the Quality of Life of Patients With Cancer: A Meta-Analysis of Randomised Controlled Trials.\",\"authors\":\"Made Satya Nugraha Gautama, Tsai-Wei Huang, Haryani Haryani, Gaviota Khalish, An-I Liu, Yan Adi Wibawa\",\"doi\":\"10.1111/jocn.17754\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cancer patients, at both early and advanced stages, face complex bio-psycho-social-spiritual problems impacting their quality of life (QoL). Managing Cancer and Living Meaningfully (CALM) therapy is a psychotherapeutic approach that helps cancer patients find hope and meaning in life, thereby improving QoL.</p><p><strong>Aim: </strong>This study aimed to critically assess the effects of CALM therapy on the QoL in cancer patients.</p><p><strong>Design: </strong>This was a systematic review and meta-analysis of randomised controlled trials (RCTs).</p><p><strong>Methods: </strong>The main outcome was QoL, and the secondary outcomes were anxiety, depression, spiritual well-being, fatigue and sleep quality. Five English databases (PubMed, Embase, Scopus, Cochrane Library and ProQuest) and one trial registry site (Clinicaltrial.gov) were searched from their inception until March 2024. The pooled effect sizes were calculated using random-effects models and expressed as standard mean difference (SMD) or weighted mean difference (WMD). Review Manager 5.4 was used for data analysis. A sensitivity analysis was done by excluding one trial at a time to check the consistency of the results on QoL. The study protocol was prospectively registered on PROSPERO (CRD42023398655).</p><p><strong>Results: </strong>Fifteen trials met the inclusion criteria for the systematic review and twelve for the meta-analysis, with a total of 1635 cancer patients. CALM therapy showed significant benefits on QoL (SMD = 1.97), spiritual well-being (WMD = 1.93) and sleep quality (SMD = -1.56) compared with usual care. It also reduced anxiety (SMD = -1.94), depression (SMD = -1.28) and fatigue (SMD = -5.86) significantly. 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Managing Cancer and Living Meaningfully (CALM) Therapy for Improving the Quality of Life of Patients With Cancer: A Meta-Analysis of Randomised Controlled Trials.
Background: Cancer patients, at both early and advanced stages, face complex bio-psycho-social-spiritual problems impacting their quality of life (QoL). Managing Cancer and Living Meaningfully (CALM) therapy is a psychotherapeutic approach that helps cancer patients find hope and meaning in life, thereby improving QoL.
Aim: This study aimed to critically assess the effects of CALM therapy on the QoL in cancer patients.
Design: This was a systematic review and meta-analysis of randomised controlled trials (RCTs).
Methods: The main outcome was QoL, and the secondary outcomes were anxiety, depression, spiritual well-being, fatigue and sleep quality. Five English databases (PubMed, Embase, Scopus, Cochrane Library and ProQuest) and one trial registry site (Clinicaltrial.gov) were searched from their inception until March 2024. The pooled effect sizes were calculated using random-effects models and expressed as standard mean difference (SMD) or weighted mean difference (WMD). Review Manager 5.4 was used for data analysis. A sensitivity analysis was done by excluding one trial at a time to check the consistency of the results on QoL. The study protocol was prospectively registered on PROSPERO (CRD42023398655).
Results: Fifteen trials met the inclusion criteria for the systematic review and twelve for the meta-analysis, with a total of 1635 cancer patients. CALM therapy showed significant benefits on QoL (SMD = 1.97), spiritual well-being (WMD = 1.93) and sleep quality (SMD = -1.56) compared with usual care. It also reduced anxiety (SMD = -1.94), depression (SMD = -1.28) and fatigue (SMD = -5.86) significantly. The sensitivity analysis confirmed the stability of these results when each trial was removed one by one.
Conclusion: CALM therapy may improve QoL, spiritual well-being, sleep quality and relieve anxiety, depression and fatigue in cancer patients.
Relevance to clinical practice: This therapy should be promoted clinically as a comprehensive psychotherapeutic approach in cancer care.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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