Abstract:

Objective To assess and compare effectiveness of non-pharmacological interventions on depression,sleep,and quality of life in breast cancer survivors. Methods The published literature that correlated with non-pharmacological interventions in breast cancer survivors in PubMed,Web of Science,MEDLINE,Embase,CNKI,Wanfang,CBM and VIP were collected. With formulated inclusion and exclusion criteria,the literature was screened,and the information was extracted;the bias risk assessment tools of Review Manager 5.3 were applied in the quality evaluation of these documents;the network relations among the studies were performed by STATA 15.0,thereby the publication bias was analyzed. The measurement of convergence was conducted;the Bayesian models were established;the probabilities of the interventions to become the best one were performed by the area under curve in the accumulative ranking probability chart. Results An amount of 22 available documents referring to 2,739 breast cancer survivors were included in this study,and we have found cognitive behavioral therapy to be the best intervention of improving depression,sleep and quality of life with the probabilities of 72%,59% and 41%. Conclusion Cognitive behavioral therapy has the best effect on the improvement of depression,sleep,and quality of life in patients with breast cancer in convalescence. It can be preferred in care intervention on breast cancer survivors.

Key words: Non-Pharmacological Intervention, Breast Neoplasms, Depression, Sleep, Quality of Life, Meta-Analysis, Rehabilitation Nursing

摘要：

目的 对多种用于改善乳腺癌康复期患者抑郁、睡眠和生活质量的非药物干预方法进行效果评估和比较。 方法 计算机检索PubMed、Web of Science、MEDLINE、Embase、中国知网、万方数据库、中国生物医学文献数据库和维普中文期刊全文数据库公开发表的改善乳腺癌康复期患者抑郁、睡眠和生活质量的非药物干预方法的相关文献。根据纳入和排除标准,筛选文献,提取文献信息;使用Review Manager 5.3中的偏倚风险评估工具对文献进行质量评价;通过STATA 15.0展现各研究之间的网状关系,并进行发表偏倚分析;进行收敛性评价,建立贝叶斯模型,通过累积排序概率图下面积呈现每个干预方法成为最佳干预的可能性。 结果 本研究共纳入22篇文献,涉及2 739例乳腺癌康复期患者。贝叶斯网状Meta分析结果显示,认知行为疗法是改善乳腺癌康复期患者抑郁、睡眠和生活质量的最佳非药物干预方法,概率分别为72%、59%和41%。 结论 认知行为疗法对乳腺癌康复期患者抑郁、睡眠和生活质量的改善效果最好,可优先考虑应用。

关键词: 非药物干预, 乳腺肿瘤, 抑郁, 睡眠, 生活质量, Meta分析, 康复护理