正念减压疗法在乳腺癌患者应用效果的系统评价再评价

Abstract: Background　Breast cancer has become the most prevalent cancer worldwide and its treatment, and recovery process often causes severe psychological distress to patients. Numerous systematic reviews (SRs) have found Mindfulness-based stress reduction (MBSR) to be effective in the psychological care of breast cancer patients. However, the quality of the original studies included in the SR, the level of evidence, and the observed indicators vary considerably, resulting in significant differences in outcome indicators. Objective　To re-evaluate the SRs on the efficacy of MBSR in breast cancer patients and to provide decision-making references for the application of MBSR in the psychological care of breast cancer patients. Methods PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, PsycINFO, JBI, China National Knowledge Infrastructure (CNKI), WanFang Data and China BioMedical Literature database (CBM) were systematically searched for SR/Meta-analysis of MBSR in breast cancer patients, searched up to July 2022. Two investigators screened the literature based on inclusion and exclusion criteria and extracted relevant information. The methodological quality, reporting norms and quality of evidence were assessed through A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Grading of Recommendations, Assessment, Development and Evaluations (GRADE), respectively. Results　A total of 14 SR were identified. AMSTAR 2 showed that only 1 SR was a high-quality study, and two essential items were missing. PRISMA statement showed that the reporting quality deficiencies were mainly in the study protocol registration, risk of inter-study bias assessment and funding sources. There were 15 outcome indicators with 73 bodies of evidence in 14 SR, and the GRADE showed that 2 were of high quality, 48 were of moderate quality, and 22 were of low quality. MBSR could improve breast cancer patients’ anxiety, depression, fatigue and stress in different degrees, and the short-term effect was significant, but the long-term effect was uncertain. Conclusion　The quality of evidence for SR for MBSR interventions in breast cancer patients is not yet high, and the methodological quality and reporting standard of the studies need to be further improved. MBSR has shown promising improvements in psychological status and other indicators in breast cancer patients, but more high-quality, large sample studies are needed to validate further.