Application of internet-delivered cognitive-behavioral therapy on symptom management in cancer patients: a Meta-analysis

Abstract

Objective To assess the application effects of internet-delivered cognitive-behavioral therapy (ICBT) on symptom management in cancer patients. Methods All randomised controlled trials (RCTs) about applying ICBT in symptom management in cancer patients in the following databases were searched from the establishment date up until 20th August 2018: Web of Science, PubMed, Cochrane Library, Embase, CBMdisc, Chinese National Knowledge Infrastructure databases (CNKI) and Wanfang. After literature screening, data extraction and quality evaluation, RevMan 5.3 software was used for meta-analysis. Results Finally, 11 RCT studies were included, totaling 2329 subjects. The results showed that ICBT was beneficial to improve mental distress [SMD=5.02, 95%CI (0.80, 9.25) , P=0.02], sleep quality [SMD=0.35, 95%CI (0.02, 0.68) , P=0.04]and cancer-related fatigue [SMD=0.50, 95%CI (0.01, 0.99) , P=0.04]; but ICBT did not have depression relieving effects in cancer patients (P>0.05) . Conclusions ICBT is beneficial to reduce psychological pain, improve sleep quality and alleviate cancer-related fatigue in cancer patients, but it has no obvious advantage in alleviating depression. Future studies still need to focus on specific cancer types and validate them with multi-center, large-sample and long-term intervention studies. Key words: Meta-analysis; Internet-delivered cognitive-behavioral therapy; Mobile health; Symptom management; Cancer