居家安宁疗护对晚期癌症患者生活质量和情绪影响的Meta分析

doi:10.3761/j.issn.0254-1769.2021.08.021

摘要/Abstract

摘要：

目的系统评价居家安宁疗护对晚期癌症患者生活质量和情绪的影响,为相关研究提供循证依据。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、CINAHL、CENTRAL、PubMed、Web of Science、Embase中关于居家安宁疗护对晚期癌症患者的随机对照试验,并追踪参考文献,检索时限为建库至2020年11月13日。由2名研究者独立筛选文献并交叉核对纳入文献质量,按照Cochrane评价手册5.1.0的质量评价方法评价纳入文献质量。采用RevMan 5.3软件进行Meta分析。结果共纳入10篇文献,包括1 720例晚期癌症患者。Meta分析结果显示,居家安宁疗护可以改善晚期癌症患者的生活质量[SMD=0.41,95%CI（0.30,0.51）,Z=7.44,P<0.001],减轻抑郁情绪[SMD=-0.29,95%CI（-0.45,-0.14）,Z=3.68,P<0.001],尚不能认为居家安宁疗护能够减轻晚期癌症患者的焦虑情绪[SMD=-0.15,95%CI（-2.12,1.82）,Z=0.15,P=0.880]。结论居家安宁疗护能够提高晚期癌症患者的生活质量,减轻患者的抑郁情绪,暂未发现能够减轻患者的焦虑情绪,需高质量、大样本研究进一步探讨居家安宁疗护对患者的影响。

关键词: 安宁疗护, 居家, 晚期癌症, 生活质量, 焦虑, 抑郁, Meta分析, 社区保健护理

Abstract:

Objective To systematically evaluate the effect of home-based hospice care on the quality of life and emotion of patients with advanced cancer,and provide evidence-based bases for future research. Methods Randomized controlled trials of home-based hospice care for patients with advanced cancer were searched in CNKI,Wanfang,VIP,CBM,CINAHL,CENTRAL,PubMed,Web of Science and Embase. Two researchers independently screened the literatures and cross checked the quality of included literature,and the references were tracked. The quality of included studies was evaluated according to the quality evaluation method of Cochrane Handbook 5.1.0. RevMan 5.3 was used for meta-analysis. Results A total of 10 pieces of literature were incorporated,including 1 720 patients with advanced cancer. The results showed that home-based hospice care can improve the quality of life of patients with advanced cancer[SMD=0.41,95%CI（0.30,0.51）,Z=7.44,P<0.001],reduce depression[SMD=-0.29,95%CI（-0.45,-0.14）,Z=3.68,P<0.001],but it can not be considered that home-based hospice care can reduce anxiety of patients with advanced cancer[SMD=-0.15,95%CI（-2.12,1.82）,Z=0.15,P=0.880]. Conclusion Home-based hospice care can improve the quality of life of patients with advanced cancer,reduce the depression of patients,but it has not been found that it can reduce the anxiety of patients,so it needs high-quality and large sample size research to further explore.

Key words: Hospice Care, Home-based, Advanced Cancer, Quality of Life, Anxiety, Depression, Meta-Analysis, Community Health Nursing

苏孟宇,王真,张玉玺,王婷,吴金凤. 居家安宁疗护对晚期癌症患者生活质量和情绪影响的Meta分析[J]. 中华护理杂志, 2021, 56(8): 1249-1254.

SU Mengyu,WANG Zhen,ZHANG Yuxi,WANG Ting,WU Jinfeng. The effect of home-based hospice care on the quality of life and emotion of patients with advanced cancer：a systematic review and meta-analysis[J]. Chinese Journal of Nursing, 2021, 56(8): 1249-1254.

图/表 6

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征

Table 1 Basic characteristics of included literatures

表2 纳入文献的方法学质量评价

Table 2 Methodological quality evaluation of included literatures

图2 居家安宁疗护对晚期癌症患者生活质量影响的亚组分析

Figure 2 Subgroup analysis of the effect of home-based hospice care on the quality of life of patients with advanced cancer

图3 居家安宁疗护对晚期癌症患者抑郁情绪影响的亚组分析

Figure 3 Subgroup analysis of the effect of home-based hospice care on depression in patients with advanced cancer

图4 居家安宁疗护对晚期癌症患者焦虑情绪的影响

Figure 4 Effect of home-based hospice care on anxiety of patients with advanced cancer

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