张苹 张小满 陈莉军

[摘要] 目的 系统评价认知行为疗法对癌症患者非正式照顾者生活质量及抑郁情绪的影响。 方法 计算机系统检索PubMed、the Cochrane Library、CINAHL、EMBASE、CBM、CNKI、万方、维普等中英文数据库，收集关于认知行为疗法对癌症患者非正式照顾者生活质量及抑郁情绪的文献，检索时间为建库至2018年7月。2名研究员根据纳入与排除标准进行文献的筛选、资料提取以及质量评价;运用Review Manager 5.3对其进行Meta分析。 结果 共纳入8项随机对照试验，癌症患者非正式照顾者946例，中途及其他原因退出者共计44例，902例完成干预，其中干预组452例，对照组450例，干预组予以认知行为疗法干预。干预组与对照组的生活质量比较，差异有统计学意义[MD = 20.15，95%CI：5.15～35.15，P = 0.008];认知行为疗法能改善癌症患者非正式照顾者的抑郁情绪。 结论 认知行为疗法可以改善癌症患者非正式照顾者的抑郁情绪，提高其生活质量。

[关键词] 认知行为疗法;癌症;非正式照顾者;抑郁;生活质量

[中图分类号] R473          [文献标识码] A          [文章編号] 1673-7210（2019）03（a）-0161-06

[Abstract] Objective To systematically evaluate the effects of cognitive behavioral therapy on the quality of life and depression of informal caregivers of patients with cancer. Methods Computer was used to search the Chinese and English databases of PubMed， the Cochrane Library， CINAHL， EMBASE， CBM， CNKI， Wanfang， VIP， etc. systematically， to collect literature on cognitive behavioral therapy for the quality of life and depression of informal caregivers of patients with cancer. The searching time was from the establishment of the database to July 2018. Two researchers conducted screening， data extraction， and quality evaluation based on inclusion and exclusion criteria， and used Review Manager 5.3 for meta-analysis. Results A total of 8 randomized controlled trials were included. There were 946 informal caregivers of patients with cancer， 44 patients quitted due to halfway or other reasons， and 902 patients completed interventions， including 452 patients in the intervention group and 450 patients in the control group. The intervention group received cognitive behavioral therapy intervention. There was significant difference in quality of life between intervention group and control group [MD = 20.15， 95%CI： 5.15-35.15， P = 0.008]. Cognitive behavioral therapy could improve depression of informal caregivers of patients with cancer. Conclusion Cognitive behavioral therapy can improve the depression and quality of life of informal caregivers of patients with cancer.

[Key words] Cognitive behavioral therapy; Cancer; Informal caregivers; Depression; Quality of life

癌症在全世界具有较高的发病率与死亡率，严重威胁人类健康。每年全世界大约有1200万人不幸诊断为癌症，近700万人死于癌症[1]。世界卫生组织的调查[2]显示，2012年癌症新增病例1400万，死亡800万。目前，癌症患者主要通过化疗进行治疗，其家属（父母、子女、配偶）、朋友及亲戚是癌症患者长期治疗中最重要的角色——照顾者。这部分照顾者未接受过专门的医学培训，故将其统称为非正式照顾者。

照顾者在癌症患者长期的治疗过程同样会出现各种生理-心理-社会健康问题。……