肿瘤学中安宁疗护应用的Meta分析：从成人患者及其家庭的角度

Meta-Analysis of Palliative Care Applications in Oncology: From the Perspective of Adult Patients and the Family

摘要: 目的：通过Meta分析评价安宁疗护对肿瘤患者及其家庭照顾者的生活质量和心理等方面的影响，为相关研究提供循证依据。方法：检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方数据库和维普数据库中随机对照试验(RCT)对肿瘤患者和/或家庭照顾者应用安宁疗护干预的研究。检索期从建库至2021年10月10日，进行文献筛选、数据提取和质量评价后，使用Review Manager5.4软件对纳入的文献进行分析。结果：共纳入17篇文献，总样本量2973例(安宁疗护组为1483例，其中肿瘤患者1156例，家庭照顾者327例；常规护理组为1454例，其中肿瘤患者1133例，家庭照顾者321例)。Meta分析结果显示：与常规护理相比，安宁疗护可以改善肿瘤患者的生活质量(P < 0.01)，可减轻肿瘤患者焦虑及抑郁情绪(P < 0.01)，减轻家庭照顾者的焦虑及抑郁情绪(P < 0.01)，降低家庭照顾者的应激水平(P < 0.01)；尚不能认为安宁疗护能够改善肿瘤患者家庭照顾者的生活质量(P = 0.76)。结论：安宁疗护可以提高肿瘤患者的生活质量，减轻肿瘤患者及其家庭照顾者的焦虑和抑郁情绪，降低家庭照顾者的应激水平，暂未发现能够改善家庭照顾者的生活质量，需高质量、大样本研究进一步探讨安宁疗护对肿瘤患者及其家庭照顾者的影响。

Abstract: Objective: To evaluate the effects of hospice care on the quality of life and psychology of cancer pa-tients and their family caregivers by meta-analysis, and to provide evidence-based evidence for re-lated studies. Methods: Search the randomized controlled trials (RCTs) in Cochrane Library, Pub-Med, Embase, Web of Science, CNKI, Wanfang Database, and VIP Databases on the application of hospice intervention to cancer patients and/or family caregivers. The retrieval period is from data-base construction to October 10, 2021. After literature screening, data extraction and quality eval-uation, Review Manager5.4 software is used to analyze the included literature. Results: A total of 17 literatures were included, with a total sample size of 2973 patients (1483 patients in the hospice nursing group, including 1156 tumor patients and 327 family caregivers; There were 1454 patients in the conventional care group, including 1133 tumor patients and 321 family caregivers). Me-ta-analysis showed that compared with conventional nursing, hospice could improve the quality of life of patients with cancer (P < 0.01), relieve anxiety and depression of patients with cancer (P < 0.01), relieve anxiety and depression of family caregivers (P < 0.01), and reduce the stress level of family caregivers (P < 0.01). It was not concluded that hospice improved the quality of life of family caregivers of cancer patients (P = 0.76). Conclusion: Hospice care can improve the quality of life of cancer patients, alleviate anxiety and depression of patients and their family caregivers, and reduce the stress level of family caregivers, temporarily not found, can improve the quality of life of the family caregivers, high quality and large sample study is needed to further explore the effect of hospice care for cancer patients and their family caregivers.