目的 评价意义中心心理治疗(meaning-centered psychotherapy,MCP)与心理教育(psychoeducation,PE)干预对癌症照顾者心理社会适应水平的效果,为构建其支持体系提供循证依据。方法 系统检索2005-2025年中英文数据库,纳入癌症照顾者心理社会干预的随机对照试验,采用RoB 2.0工具评价文献质量,基于贝叶斯框架开展Meta分析、亚组分析整合数据。结果 共纳入10项研究,共计1533名照顾者。MCP和PE均能提升照顾者心理社会适应水平(SMD=0.13,95%CI:0.07~0.18,P<0.001),且MCP效果较优(SMD=0.25,95%CI:0.10~0.41)。进一步亚组分析显示:在干预剂量强度方面,高剂量干预效应更优(SMD=0.38,95%CI:0.14~0.61,P=0.002);在干预对象方面,仅针对照顾者干预效果更显著(SMD=0.17,95%CI:0.07~0.27,P=0.001)。结论 面向癌症照顾者的心理社会干预效应明确,在现有证据下,MCP显示优于PE的趋势,但需更多临床研究证实以制定个性化支持策略。

Objective To evaluate the effects of Meaning-centered Psychotherapy (MCP) and Psychoeducation (PE) interventions on the psychosocial adaptation level of cancer caregivers,and to provide evidence-based references for the construction of supporting systems for this population.Methods A total of 8 Chinese and English databases were systematically searched from 2005 to 2025.Randomized controlled trials on psychosocial interventions for cancer caregivers were included.The RoB 2.0 tool was used to evaluate the literature quality,and meta-analysis as well as subgroup analysis were performed to integrate data based on the Bayesian framework.Results A total of 10 studies involving 1533 caregivers were included.Compared with routine care,both MCP and PE could significantly improve the psychosocial adaptation level of caregivers (SMD=0.13,95%CI: 0.07-0.18,P<0.001),and MCP yielded the optimal effect (SMD=0.25,95%CI: 0.10-0.41).Further subgroup analysis showed the high-dose intervention presented a better effect (SMD=0.38,95%CI: 0.14-0.61,P=0.002) in terms of intervention dosage and intensity,and interventions targeting only caregivers achieved more remarkable effects (SMD=0.17,95%CI: 0.07-0.27,P=0.001) in terms of intervention recipients.Conclusions Psychosocial interventions exert definite effects on cancer caregivers.Based on current limited evidence,MCP shows a tendency to be superior to PE.More clinical studies are needed for verification so as to formulate individualized support strategies.

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