A growing body of research demonstrates the feasibility and efficacy of psychological interventions for adult patients with advanced cancer. Findings from quantitative studies of psychotherapeutic interventions with primary psychological outcomes for such patients are reviewed here and recommendations for best practice are made. We consider these interventions according to three broad phases in which they are most commonly applied: soon after diagnosis of advanced cancer, when living with the disease, and at or near the end of life. Cumulative evidence from well-designed studies demonstrates the efficacy of psychosocial interventions for patients with advanced disease to relieve and prevent depression, anxiety, and distress related to dying and death, as well as to enhance the sense of meaning and preparation for end of life. Individual and couple-based interventions have been proven to be most feasible, and the development and use of tailored and validated measures has enhanced the rigor of research and clinical care. Palliative care nurses and physicians can be trained to deliver many such interventions, but a core of psychosocial clinicians, including social workers, psychologists, and psychiatrists, is usually required to train other health professionals in their delivery and to ensure their quality. Few of the interventions for which there is evidence of effectiveness have been routinely incorporated into oncology or palliative care. Advocacy on the basis of this evidence is required to build psychosocial resources in cancer treatment settings and to ensure that psychological care receives the same priority as other aspects of palliative care in oncology.

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晚期疾病患者的心理干预：对肿瘤学和姑息治疗的影响

越来越多的研究证明了心理干预对晚期癌症成年患者的可行性和有效性。本文回顾了对此类患者的主要心理结果的心理治疗干预的定量研究结果，并提出了最佳实践建议。我们根据最常应用的三个广泛阶段来考虑这些干预措施：在诊断出晚期癌症后不久、患有疾病时以及在生命结束时或接近生命尽头。精心设计的研究积累的证据表明，社会心理干预对晚期疾病患者有效，可缓解和预防与死亡和死亡相关的抑郁、焦虑和痛苦，并增强意义感和为临终做好准备。个人和夫妻为基础的干预措施已被证明是最可行的，而量身定制和经过验证的措施的开发和使用增强了研究和临床护理的严谨性。姑息治疗护士和医生可以接受培训以提供许多此类干预措施，但通常需要社会心理临床医生的核心，包括社会工作者、心理学家和精神病学家，来培训其他卫生专业人员提供服务并确保他们的质量。有证据表明有效的干预措施很少被常规纳入肿瘤学或姑息治疗。需要基于此证据进行宣传，以在癌症治疗环境中建立社会心理资源，并确保心理护理与肿瘤学姑息治疗的其他方面获得同等的优先权。