系統性文獻回顧方式探討處置介入對前列腺癌病患及其伴侶婚姻調適之成效

背景：前列腺癌的診斷與治療常對病患及其伴侶的婚姻調適造成衝擊。目前已有介入型研究企圖改善前列腺癌病患及其伴侶的婚姻調適，但仍缺乏運用系統性文獻回顧方式將研究結果做整合。目的：本研究運用系統性文獻回顧方式，統整處置介入對前列腺癌病患及其伴侶婚姻調適的成效。方法：以事先擬定好的關鍵詞，搜尋2004年至2014年發表於六個電子資料庫文章。另以人工搜尋方式檢視選入文章之參考文獻，以完整納入相關文章，並以Jadad量表評價文章品質。結果：共有5篇隨機控制試驗研究及1篇隨機分派交叉試驗研究符合選入標準，有5篇文章同時針對病患及其伴侶進行處置介入，處置介入涵蓋提供資訊、增加親密感、社會支持、性功能藥物及性復健。整體而言，處置介入不能顯著提升前列腺癌病患及其伴侶的婚姻調適，其可能與研究樣本數小、處置介入時間較短及樣本在參與研究前即有良好婚姻調適有關。但其中有一篇文章顯示，提供資訊處置介入以提升病患婚姻調適的效果量達1.02，對伴侶則達0.5。結論／實務應用：本系統性文獻回顧顯示，可能礙於研究設計上的限制，以至於處置介入對提升病患及其伴侶的婚姻調適成效不明顯。建議未來仍需來自不同文化背景、大樣本、長期追蹤的研究，以深入瞭解處置介入對婚姻調適的成效。

關鍵字

前列腺癌；婚姻調適；處置介入；系統性文獻回顧

並列摘要

Background: The diagnosis and treatment of prostate cancer affect both patients and their spouses in terms of marital adjustment. Although many interventional studies have been conducted to improve the cancer-related marital adjustment process, few studies have reviewed the results of these studies systematically. Purpose: The purpose of the present study was to conduct a systematic review in order to explore the intervention effects on the marital adjustment of patients with prostate cancer and of their spouses. Method: A keyword search was performed on six widely used research databases to identify relevant articles that were published between 2004 and 2014. In addition, the references in the identified articles were examined to identify suitable articles for further review. The Jadad scale was employed to evaluate the quality of the reviewed articles. Results: Five randomized controlled trials and one randomized placebo‐controlled cross over trial were accepted and included in the present review. Five of the studies conducted interventions on both patients and their spouses. The majority of interventions included the following activities: providing information, recommending strategies for enhancing intimacy, organizing social support, prescribing sexual medicine, and providing sexual rehabilitation. None of the studies found that the developed interventions significantly improved the marital adjustment of the affected couples. This lack of significant improvement may relate to the small sample sizes, lower doses used, and the inclusion of participants with adequate marital adjustment prior to the study. However, one of the studies reported an effect size for improving martial adjustment of 1.02 for the patients and 0.5 for their spouses. Conclusions/Implications for Practice: Because of the limited study designs, the results of the present review study indicate that the examined interventions did not significantly affect the marital adjustment of patients with prostate cancer or their spouses. Further research investigating different cultural backgrounds, larger samples, and long‐term follow‐up studies should be conducted in order to elucidate the effects of intervention measures on marital adjustment.

並列關鍵字

prostate cancer ； marital adjustment ； intervention ； systematic review

參考文獻

American Cancer Society. (2015). Cancer facts and figures 2015. Retrieved from http://www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2015/index

Badr, H., & Taylor, C. L. C. (2009). Sexual dysfunction and spousal communication in couples coping with prostate cancer. Psycho-Oncology, 18(7), 735-746.

Berg, C. A., Wiebe, D. J., Butner, J., Bloor, L., Bradstreet, C., Upchurch, R., ... Patton, G. (2008). Collaborative coping and daily mood in couples dealing with prostate cancer. Psychology and Aging, 23(3), 505-516.

Burnet, K. L., Parker, C., Dearnaley, D., Brewin, C. R., & Watson, M. (2007). Does active surveillance for men with localized prostate cancer carry psychological morbidity? BJU International, 100(3), 540-543.

*Canada, A. L., Neese, L. E., Sui, D., & Schover, L. R. (2005). Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma. Cancer, 104(12), 2689-2700.

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系統性文獻回顧方式探討處置介入對前列腺癌病患及其伴侶婚姻調適之成效

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