{"title":"结直肠癌患者造口术对身体形象和性功能的影响：一项系统综述和荟萃分析。","authors":"Claudia Redeker, Elizabeth Grunfeld, Anne Miles","doi":"10.1002/pon.70249","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Body image disturbance and sexual dysfunction are two of the most common issues reported by patients with colorectal cancer (CRC). The objective of our systematic review and meta-analysis was to examine the effects of an ostomy on body image (BI) and sexual dysfunction (SX) in patients with CRC.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we searched seven databases (MEDLINE, PsychINFO, EMBASE, The Cochrane Library, PubMed, CINAHL, WEB of SCIENCE) covering articles published in English between January 1st, 2000 and July 20, 2024. Statistical analysis was carried out using the Comprehensive Meta-Analysis (CMA) version 4 software.</p><p><strong>Results: </strong>Of 6321 identified articles, 92 met the inclusion criteria, totalling 27,039 patients. Patients with an ostomy reported significantly more body image concerns (g = -0.467 (95% CI -0.546 to -0.388), p < 0.001; prediction interval (PI): -1.046 to 0.112) and sexual dysfunction (g = -0.331 (95% CI -0.406 to -0.256), p < 0.001; PI: -0.894 to 0.232). Meta-regression showed that for BI, publication date and the choice of questionnaire explained 30% of the variance in effect size (R<sup>2</sup>analog = 0.30, df = 3, p < 0.05). For SX, gender and publication date explained 31% of the variance in effect size (R<sup>2</sup>analog = 0.3, df = 2, p < 0.001).</p><p><strong>Conclusion: </strong>The findings revealed that patients with an ostomy, compared to those without, experience significantly higher levels of BI concerns and SX, with moderate-to-large effect sizes observed. However, there was significant heterogeneity, indicated by the broad prediction interval across studies. Results from the meta-regression suggested that the measurement tools, gender and publication date contributed to the observed variability. Future research should explore additional factors that influence outcomes in body image and sexual health for individuals with lived experience of CRC.</p><p><strong>Prospero registration: </strong>No CRD42020167716.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 8","pages":"e70249"},"PeriodicalIF":3.5000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Impact of an Ostomy on Body Image and Sexual Function of Patients With Colorectal Cancer: A Systematic Review and Meta-Analysis.\",\"authors\":\"Claudia Redeker, Elizabeth Grunfeld, Anne Miles\",\"doi\":\"10.1002/pon.70249\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Body image disturbance and sexual dysfunction are two of the most common issues reported by patients with colorectal cancer (CRC). The objective of our systematic review and meta-analysis was to examine the effects of an ostomy on body image (BI) and sexual dysfunction (SX) in patients with CRC.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we searched seven databases (MEDLINE, PsychINFO, EMBASE, The Cochrane Library, PubMed, CINAHL, WEB of SCIENCE) covering articles published in English between January 1st, 2000 and July 20, 2024. Statistical analysis was carried out using the Comprehensive Meta-Analysis (CMA) version 4 software.</p><p><strong>Results: </strong>Of 6321 identified articles, 92 met the inclusion criteria, totalling 27,039 patients. Patients with an ostomy reported significantly more body image concerns (g = -0.467 (95% CI -0.546 to -0.388), p < 0.001; prediction interval (PI): -1.046 to 0.112) and sexual dysfunction (g = -0.331 (95% CI -0.406 to -0.256), p < 0.001; PI: -0.894 to 0.232). Meta-regression showed that for BI, publication date and the choice of questionnaire explained 30% of the variance in effect size (R<sup>2</sup>analog = 0.30, df = 3, p < 0.05). For SX, gender and publication date explained 31% of the variance in effect size (R<sup>2</sup>analog = 0.3, df = 2, p < 0.001).</p><p><strong>Conclusion: </strong>The findings revealed that patients with an ostomy, compared to those without, experience significantly higher levels of BI concerns and SX, with moderate-to-large effect sizes observed. However, there was significant heterogeneity, indicated by the broad prediction interval across studies. Results from the meta-regression suggested that the measurement tools, gender and publication date contributed to the observed variability. Future research should explore additional factors that influence outcomes in body image and sexual health for individuals with lived experience of CRC.</p><p><strong>Prospero registration: </strong>No CRD42020167716.</p>\",\"PeriodicalId\":20779,\"journal\":{\"name\":\"Psycho‐Oncology\",\"volume\":\"34 8\",\"pages\":\"e70249\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psycho‐Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/pon.70249\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psycho‐Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pon.70249","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：身体形象障碍和性功能障碍是结直肠癌（CRC）患者报告的两个最常见的问题。我们的系统回顾和荟萃分析的目的是检查造口术对CRC患者身体形象（BI）和性功能障碍（SX）的影响。方法：在本系统综述和荟萃分析中，我们检索了7个数据库（MEDLINE, PsychINFO， EMBASE, The Cochrane Library, PubMed， CINAHL, WEB of SCIENCE），涵盖了2000年1月1日至2024年7月20日期间发表的英文文章。采用综合meta分析（Comprehensive Meta-Analysis， CMA） 4版软件进行统计分析。结果：在6321篇纳入的文献中，92篇符合纳入标准，共计27039例患者。接受造口术的患者报告了更多的身体形象担忧（g = -0.467 (95% CI -0.546至-0.388),p 2analog = 0.30, df = 3, p 2analog = 0.3, df = 2, p）。结论：研究结果显示，与未接受造口术的患者相比，接受造口术的患者有更高水平的BI担忧和SX，观察到中等到较大的效应。然而，各研究的预测区间较宽，表明存在显著的异质性。meta回归的结果表明，测量工具、性别和出版日期对观察到的变异性有影响。未来的研究应该探索影响结直肠癌患者身体形象和性健康结果的其他因素。普洛斯彼罗注册号：CRD42020167716。
The Impact of an Ostomy on Body Image and Sexual Function of Patients With Colorectal Cancer: A Systematic Review and Meta-Analysis.
Background: Body image disturbance and sexual dysfunction are two of the most common issues reported by patients with colorectal cancer (CRC). The objective of our systematic review and meta-analysis was to examine the effects of an ostomy on body image (BI) and sexual dysfunction (SX) in patients with CRC.
Methods: In this systematic review and meta-analysis, we searched seven databases (MEDLINE, PsychINFO, EMBASE, The Cochrane Library, PubMed, CINAHL, WEB of SCIENCE) covering articles published in English between January 1st, 2000 and July 20, 2024. Statistical analysis was carried out using the Comprehensive Meta-Analysis (CMA) version 4 software.
Results: Of 6321 identified articles, 92 met the inclusion criteria, totalling 27,039 patients. Patients with an ostomy reported significantly more body image concerns (g = -0.467 (95% CI -0.546 to -0.388), p < 0.001; prediction interval (PI): -1.046 to 0.112) and sexual dysfunction (g = -0.331 (95% CI -0.406 to -0.256), p < 0.001; PI: -0.894 to 0.232). Meta-regression showed that for BI, publication date and the choice of questionnaire explained 30% of the variance in effect size (R2analog = 0.30, df = 3, p < 0.05). For SX, gender and publication date explained 31% of the variance in effect size (R2analog = 0.3, df = 2, p < 0.001).
Conclusion: The findings revealed that patients with an ostomy, compared to those without, experience significantly higher levels of BI concerns and SX, with moderate-to-large effect sizes observed. However, there was significant heterogeneity, indicated by the broad prediction interval across studies. Results from the meta-regression suggested that the measurement tools, gender and publication date contributed to the observed variability. Future research should explore additional factors that influence outcomes in body image and sexual health for individuals with lived experience of CRC.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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