文章｜心理干预对乳腺癌幸存者治疗依从性和生活质量的有效性：系统评价和meta分析

心理干预对乳腺癌幸存者治疗依从性和生活质量的有效性：系统评价和meta分析

关键词：心理干预；乳腺癌幸存者；治疗依从性；生活质量；系统审查；meta分析

摘要：

目的：评估心理干预对乳腺癌幸存者治疗依从性和生活质量的影响。 方法：对 42 项随机对照试验（2002-2023 年）进行系统回顾和荟萃分析。干预措施包括认知行为疗法（CBT）、基于正念的干预措施（MBI）和支持表达团体疗法（SEGT）。评估的主要结果是治疗依从性和生活质量。 主要发现：治疗依从性：心理干预显着提高了依从性（RR = 1.27，95% CI：1.18–1.37），其中 CBT 的效果最大（RR = 1.35）。持续≥8周的干预措施更有效。 生活质量：观察到适度改善（SMD = 0.45，95% CI：0.36-0.54），其中 MBI 的影响最强（SMD = 0.56）。 ≥12周的干预产生了更好的结果。元回归：干预时间越长，对依从性和生活质量的影响越大。 结论：CBT 和 MBI 显着提高乳腺癌幸存者的治疗依从性和生活质量，特别是在干预时间较长的情况下。心理支持应纳入综合癌症护理。

Effectiveness of psychological interventions on treatment adherence and quality of life in breast cancer survivors: A systematic review and meta-analysis

Keywords: psychological interventions; breast cancer survivors; treatment adherence; quality of life; systematic review; meta-analysis

Abstract

Objective: To evaluate the impact of psychological interventions on treatment adherence and quality of life in breast cancer survivors. Methods: A systematic review and meta-analysis of 42 randomized controlled trials (2002–2023). Interventions included Cognitive-Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), and Supportive-Expressive Group Therapy (SEGT). Primary outcomes assessed were treatment adherence and quality of life. Key Findings: Treatment Adherence: Psychological interventions significantly improved adherence (RR = 1.27, 95% CI: 1.18–1.37), with CBT showing the largest effect (RR = 1.35). Interventions lasting ≥8 weeks were more effective. Quality of Life: Moderate improvements were observed (SMD = 0.45, 95% CI: 0.36–0.54), with MBI having the strongest impact (SMD = 0.56). Interventions of ≥12 weeks yielded better outcomes. Meta-regression: Longer interventions were linked to larger effects for both adherence and quality of life. Conclusions: CBT and MBI significantly enhance treatment adherence and quality of life in breast cancer survivors, especially with longer interventions. Psychological support should be integrated into comprehensive cancer care.