Hubungan Perawatan Paliatif Dini yang Terintegrasi dengan Kesejahteraan Psikologis pada Kanker Saluran Cerna Stadium Lanjut

Abstract

Advanced gastrointestinal (GI) cancer is very significant for patients and their families. The role of integrated palliative care (PC) in alleviating this suffering has become an interesting subject, although the available evidence is still mixed. This systematic review aims to synthesize the available data on the effects of integrated PC on the psychological well-being of this patient population, focusing on significant findings. A systematic search method was used to identify relevant studies, including randomized controlled trials (RCTs) and systematic reviews, that investigated the relationship between integrated PC interventions and psychological outcomes in patients with advanced GI cancer. Data on study design, patient population, type of intervention, comparator, and primary outcomes (such as quality of life, depression, anxiety, and resilience) were extracted. Risk of bias assessment was performed using the Cochrane Risk of Bias (RoB 2.0) tool for RCTs and ROBINS-I for non-randomized studies. The results of the evidence show a positive, statistically and clinically significant relationship between early PC integration and patient psychological well-being, particularly in reducing symptoms of depression and anxiety. However, significant heterogeneity was observed among studies, largely due to variations in intervention models (e.g., inpatient, outpatient, or nurse-led). Core psychological domains such as resilience, spirituality, and social support were consistently identified as key mediators of well-being.