Ki Sum Samson Wong, Mu-Hsing Ho, Tianxue Hou, Chia-Chin Lin
{"title":"“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。","authors":"Ki Sum Samson Wong, Mu-Hsing Ho, Tianxue Hou, Chia-Chin Lin","doi":"10.1016/j.jpainsymman.2025.08.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>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.</p><p><strong>Objectives: </strong>To evaluate the effects of MFI on cancer-related physical and psychological symptoms.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"\\\"Having a Why to Live Can Bear Almost Any How\\\"-Meaning-focused Interventions on Cancer-related Clinical Symptoms: Systematic Review and Meta-Analysis.\",\"authors\":\"Ki Sum Samson Wong, Mu-Hsing Ho, Tianxue Hou, Chia-Chin Lin\",\"doi\":\"10.1016/j.jpainsymman.2025.08.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>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.</p><p><strong>Objectives: </strong>To evaluate the effects of MFI on cancer-related physical and psychological symptoms.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":16634,\"journal\":{\"name\":\"Journal of pain and symptom management\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of pain and symptom management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jpainsymman.2025.08.014\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpainsymman.2025.08.014","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
"Having a Why to Live Can Bear Almost Any How"-Meaning-focused Interventions on Cancer-related Clinical Symptoms: Systematic Review and Meta-Analysis.
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.
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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