护理学报 ›› 2019, Vol. 26 ›› Issue (8): 31-36.doi: 10.16460/j.issn1008-9969.2019.08.031
刘熠, 欧阳艳琼, 黄毅, 聂小菲
摘要: 目的 评价正念减压疗法对乳腺癌患者心理健康及生活质量的作用效果。方法 计算机检索Cochrane Library、PubMed、Web of Science、EMbase、CINAHL Complete、中国知网、万方数据库、维普数据库中研究正念减压疗法对乳腺癌患者焦虑、抑郁、压力及生活质量作用效果的随机对照试验。检索年限从建库到2018年11月31日。文献质量评价依照Cochrane Review Handbook 5.1.0质量评价标准,质量评价后运用RevMan 5.3软件进行Meta分析。结果 共检索文献615篇,经筛选后纳入12篇。Meta分析结果表明,正念减压疗法可以改善乳腺癌患者干预后的压力程度[MD=-4.81,95%CI(-5.25,-4.36),P<0.001],抑郁状况[SMD=-0.66,95%CI(-0.98,-0.33),P<0.001]以及焦虑情绪[SMD=-0.67,95%CI(-1.06,-0.29),P<0.001]。同时,随访后的压力程度[MD=-0.90,95%CI(-1.39,-0.42),P<0.001]和焦虑情绪[SMD=-0.30,95%CI(-0.57,-0.03),P=0.030]也有所缓解。结论 正念减压疗法可以有效缓解乳腺癌患者干预后及长期的压力程度和焦虑情绪,但对抑郁程度只有干预后的效果,而对生活质量的短期和长期效果均不显著。
中图分类号:
[1] 陈万青,郑荣寿,张思维,等.2013年中国恶性肿瘤发病和死亡分析[J].中国肿瘤,2017,26(1):1-7. DOI:10.11735/j.issn.1004-0242.2017.01.A001. [2] 师金,梁迪,李道娟,等. 全球女性乳腺癌流行情况研究[J].中国肿瘤,2017,26(9):683-690.DOI:10.11735/j.issn.1004-0242.2017.09.A006. [3] 柏尚柱.乳腺癌在中国的流行状况和疾病特征[J].世界最新医学信息文摘,2017,17(41):253;256. DOI:10.3969/j.issn.1671-3141.2017.41.207. [4] Suppli N P, Johansen C, Kessing L V, et al.Survival after Early-stage Breast Cancer of Women Previously Treated for Depression: A Nationwide Danish Cohort Study[J]. J Clin Oncol,2017,35(3):334-342.DOI:10.1200/JCO.2016.68.8358. [5] Matchim Y, Armer J M, Stewart B R.Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion[J]. Oncol Nurs Forum, 2011, 38(2):61-71. DOI:10.1188/11.ONF.E61-E71. [6] Rush S E, Sharma M.Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care:A Systematic Review[J]. J Evid Based Complementary Altern Med, 2017,22(2):348-360.DOI:10.1177/2156587216661467. [7] 杨笑梅,曾凡,刘小红,等.正念训练概述及其在癌症患者中的应用进展[J].护理学报,2016,23(17):42-46. DOI:10.16460/j.issn1008-9969.2016.17.042. [8] Haller H, Winkler M M, Klose P,et al.Mindfulness-based Interventions for Women with Breast Cancer: An Updated Systematic Review and Meta-analysis[J]. Acta Oncologica,2017,56(12):1665-1676. DOI:10.1080/0284186X.2017.1342862. [9] Cifu G, Power M C, Shomstein S, et al.Mindfulness-based Interventions and Cognitive Function among Breast Cancer Survivors: A Systematic Review[J]. BMC Cancer,2018,18(1):1163-1176. DOI:10.1186/s12885-018-5065-3. [10] Zhang Q X, Zhao H, Zheng Y N.Effectiveness of Mindfulness-based Stress Reduction (MBSR) on Symptom Variables and Health-related Quality of Life in Breast Cancer Patients: A Systematic Review and Meta-analysis[J]. Support Care Cancer, 2019, 27(3):771-781.DOI:10.1007/s00520-018-4570-x. [11] Zhang J, Xu R, Wang B, et al.Effects of Mindfulness-based Therapy for Patients with Breast Cancer: A Systematic Review and Meta-analysis[J]. Complement Ther Med, 2016, 26:1-10. DOI:10.1016/j.ctim.2016.02.012. [12] Cramer H, Lauche R, Paul A, et al.Mindfulness-based Stress Reduction for Breast Cancer-A Systematic Review and Meta-analysis[J]. Curr Oncol,2012, 19(5):343-352. DOI:10.3747/co.19.1016. [13] Zainal N Z, Booth S, Huppert F A.The Efficacy of Mindfulness-based Stress Reduction on Mental Health of Breast Cancer Patients: A Meta-analysis[J]. Psycho Oncol, 2013, 22(7):1457-1465. DOI: 10.1002/pon.3171. [14] Castanhel F D, Liberali R.Mindfulness-Based Stress Reduction on Breast Cancer Symptoms: Systematic Review and Meta-analysis[J]. Einstein (Sao Paulo),2018,16(4). DOI:10.31744/einstein_journal/2018RW4383. [15] Huang H P, He M, Wang H Y, et al.A Meta-analysis of the Benefits of Mindfulness-based Stress Reduction (MBSR) on Psychological Function among Breast Cancer (BC) Survivors[J]. Breast Cancer,2016, 23(4):568-576. DOI:10.1007/s12282-015-0604-0. [16] 曾艳丽,王国富,胡秀英,等.正念减压对乳腺癌干预效果的Meta分析[J].现代临床医学,2017,43(1):60-63,66. DOI:10.11851/j.issn.1673-1557.2017.01.021. [17] 杨丽梅,刘美玲,张珺.正念减压疗法对乳腺癌患者心理健康及生存质量影响的系统评价[J].护理学杂志,2015,30(20):23-27. DOI:10.3870/j.issn.1001-4152.2015.20.023. [18] 张青月,肖珊,阎玲,等.正念减压疗法在乳腺癌患者中应用效果的Meta分析[J].护理管理杂志, 2018,18(11):761-765. DOI:10.3969/j.issn.1671-315x.2018.11.001. [19] 王芹,章新琼,王秋萍,等.正念减压法对癌症患者知觉压力与睡眠障碍干预效果的系统评价[J].重庆医学,2017,46(25):3547-3550. DOI:10.3969/j.issn.1671-8348.2017.25.030. [20] Higgins J P T,Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[EB/OL]. (2011-04-10) [2018-01-28].http://handbook-5-1.cochrane.org/. [21] Bower J E, Crosswell A D, Stanton A L,et al.Mindfulness Meditation for Younger Breast Cancer Survivors:A Randomized Controlled Trial[J]. Cancer, 2014, 121(8):1231-1240. DOI:10.1002/cncr.29194. [22] Boyle C C, Stanton A L, Ganz P A, et al.Improvements in Emotion Regulation Following Mindfulness Meditation:Effects on Depressive Symptoms and Perceived Stress in Younger Breast Cancer Survivors[J]. J Consult Clin Psychol,2017,85(4):397-402. DOI:10.1037/ccp0000186. [23] Zhang J Y,Zhou Y Q, Feng Z W, et al.Randomized Controlled Trial of Mindfulness-based Stress Reduction (MBSR) on Posttraumatic Growth of Chinese Breast Cancer Survivors[J]. Psychol Health Med, 2017,22(1):94-109. DOI:10.1080/13548506.2016.1146405. [24] Reich R R.Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients:Immediate and Sustained Effects across Multiple Symptom Clusters[J]. J Pain Symptom Manage,2016,53(1):85-95.DOI:10.1016/j.jpainsy-mman.2016.08.005. [25] Lee C E, Kim S, Kim S, et al.Effects of a Mindfulness-based Stress Reduction Program on the Physical and Psychological Status and Quality of Life in Patients with Metastatic Breast Cancer[J]. Holist Nurs Pract, 2017, 31(4):260-269. DOI:10.1097/HNP.0000000000000220. [26] Hoffman C J, Ersser S J, Hopkinson J B, et al.Effectiveness of Mindfulness-based Stress Reduction in Mood, Breast- and Endocrine-related Quality of Life, and Well-being in Stage 0 to III Breast Cancer: A Randomized Controlled Trial[J]. J Clin Oncol, 2012, 30(12):1335-1342. DOI:10.1200/JCO.2010.34.0331. [27] Lengacher C A, Reich R R, Paterson C L, et al.Examination of Broad Symptom Improvement Resulting from Mindfulness-based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial[J]. J Clin Oncol, 2016, 34(24):2827-2834. DOI:10.1200/JCO.2015.65.7874. [28] 张佳媛,周郁秋,张全志,等.正念减压疗法对乳腺癌患者知觉压力及焦虑抑郁水平的影响[J].中华护理杂志,2015,50(2):189-193.DOI:10.3761/j.issn.0254-1769.2015.02.014. [29] 陈钦羡. 正念减压法在乳腺癌根治术患者护理中的应用价值分析[J].医学理论与实践,2017,30(19):2957-2958. DOI:10.19381/j.issn.1001-7585.2017.19.082. [30] 赵丹,李宁,任小红.正念减压对乳腺癌术后患者心理弹性的影响[J].检验医学与临床,2016,13(24):3554-3555. DOI:10.3969/j.issn.1672-9455.2016.24.049. [31] 周方慧,孙景云.正念训练对乳腺癌患者术后不良心理及生活质量的影响[J].解放军护理杂志,2015,32(7):21-23. DOI:10.3969/j.issn.1008-9993.2015.07.006. [32] 苗卫莉. 正念减压疗法对乳腺癌术后患者焦虑抑郁状态的影响[J].国际医药卫生导报,2015,21(22):3373-3375. DOI:10.3760/cma.j.issn.1007-1245.2015.22.043. [33] 吴小婷,章新琼,王秋萍,等.癌症患者心理弹性干预的研究进展[J].中华护理杂志,2017,52(3):316-320. DOI:10.3761/j.issn.0254-1769.2017.03.013. [34] Eskelinen M, Korhonen R, Selander T, et al.Beck Depression Inventory as a Predictor of Long-term Outcome among Patients Admitted to the Breast Cancer Diagnosis Unit: A 25-year Cohort Study in Finland[J]. Anticancer Res, 2017, 37(2):819-824. DOI:10.21873/anticanres.11383. [35] 黄晓燕,胡雁,陆箴琦,等.网络支持项目对乳腺癌患者抑郁和疾病知识水平的影响[J].护理学杂志,2011,26(2):1-4. DOI:10.3870/hlxzz.2011.02.001. [36] 刘婷,李来有,宿桂霞.乳腺癌患者不同时期心理干预研究进展[J].护理学报,2017,24(23):19-22. DOI:10.16460/j.issn1008-9969.2017.23.019. |
[1] | 黄媛媛, 傅巧美, 刘光香, 白雅馨, 张青. 肾移植患者基于“互联网+”延续护理的效果观察[J]. 护理学报, 2020, 27(8): 69-72. |
[2] | 裴露斯, 杨雪梅, 翟田田, 赵亚芸, 冯兰棱, 张迁. 冷冻疗法降低化疗患者口腔黏膜炎发生的Meta分析[J]. 护理学报, 2020, 27(6): 23-28. |
[3] | 陈雯, 尹朱丹, 王赛男, 厉姝岑, 张雪芳. 接纳与承诺疗法对慢性疼痛干预效果的Meta分析[J]. 护理学报, 2020, 27(5): 22-27. |
[4] | 张丹妮, 朱慧, 谢传艺, 陈肖敏. 乳腺癌患者配偶照顾体验质性研究的Meta整合[J]. 护理学报, 2020, 27(4): 32-36. |
[5] | 李寅翠, 刘云, 李莹, 韩雪, 孟嘉. 术前睡眠质量对全膝关节表面置换患者术后早期康复及生活质量的影响[J]. 护理学报, 2020, 27(4): 42-47. |
[6] | 王佳, 郝飞, 周慧敏. 叠加敷料粘贴法对乳腺癌患者PICC置管部位接触性皮炎的效果观察[J]. 护理学报, 2020, 27(4): 63-66. |
[7] | 朱一凡, 陈芷谦, 郭巧红, 苏娅丽. 196例乳腺癌化疗患者尊严现状及影响因素分析[J]. 护理学报, 2020, 27(12): 33-37. |
[8] | 刘敏, 刘安诺, 吴德全, 高宇, 陈国红, 朱桂月, 张萌, 马雯, 丁翠路. 运动干预对2型糖尿病老年患者步行功能影响的Meta分析[J]. 护理学报, 2020, 27(11): 40-45. |
[9] | 谢莹莹, 黄秀美, 尹安春, 王艾红, 何月月. 乳腺癌幸存者重返工作岗位现状及影响因素的研究进展[J]. 护理学报, 2019, 26(6): 27-31. |
[10] | 梁欣, 高祖梅, 张海元, 海容, 邓文芳. 父母陪伴下麻醉诱导对患儿围术期影响的Meta分析[J]. 护理学报, 2019, 26(6): 32-37. |
[11] | 杜红娣, 刘彩云, 刘晓萱, 王琳琳, 李莹, 霍晓鹏. 基于蒙台梭利教育理论干预对轻中度老年痴呆患者认知功能及生活质量的影响[J]. 护理学报, 2019, 26(5): 59-62. |
[12] | 朱冰洁, 李佳倩, 黄孟秋, 王蕊, 阎玲. 154例乳腺癌化疗患者症状管理自我效能影响因素分析[J]. 护理学报, 2019, 26(18): 42-46. |
[13] | 孙烯辉, 杨丽, 黄德斌, 张桂宁, 李琳, 廖婷婷, 邱丽燕, 巫雪花. 机械通气患者胸部物理治疗效果的Meta分析[J]. 护理学报, 2019, 26(17): 31-36. |
[14] | 于歌, 崔金金. 二元应对模式对慢性心力衰竭患者生活质量及其配偶间亲密关系的影响[J]. 护理学报, 2019, 26(16): 63-67. |
[15] | 邓波, 江波, 陈静文, 李显蓉. 自体富血小板纤维蛋白治疗慢性伤口有效性与安全性的Meta分析[J]. 护理学报, 2019, 26(13): 6-11. |
|