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Yang Y, Yi Y, Shi X, Yang X. Comparative efficacy of psychological interventions on anxiety and depression in patients with cancer: A systematic review and network meta-analysis. Medicine (Baltimore) 2024; 103:e38155. [PMID: 38787974 PMCID: PMC11124676 DOI: 10.1097/md.0000000000038155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 04/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Numerous studies have demonstrated that psychological interventions are effective in alleviating anxiety and depression in patients with cancer. However, the optimal psychological intervention to alleviate anxiety and depression in patients with cancer remains unknown. This study was carried out to compare and rank the comparative effectiveness of various psychological interventions on anxiety and depression in patients with cancer. METHODS Databases, namely PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CNKI, WanFang, VIP and CBM were systematically searched from their inception dates to December 2023 for randomized controlled trials of psychological interventions for anxiety and depression in patients with cancer. Utilizing the Cochrane Review Manager 5.4, we evaluated the risk of bias in the studies included in the current study based on the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The NMA was conducted using STATA 15.0. This study did not involve human participants and therefore did not require ethical approval. RESULTS Thirty-one randomized controlled trials involving 3471 participants were included. MT [SMD = 1.35, 95% CI (0.76, 1.93)] and cognitive behavioral therapy (CBT) [SMD = 0.97, 95% CI (0.53, 1.42)] were superior to usual care in alleviating anxiety. Besides, interpersonal psychotherapy (IPT) [SMD = 1.17, 95% CI (0.06, 2.28)], CBT [SMD = 0.97, 95 % CI (0.63, 1.30)], and MT [SMD = 0.93, 95% CI (0.35, 1.50)] were superior to usual care in alleviating depression. In addition, CBT was superior to family therapy in alleviating depression [SMD = 0.73, 95% CI (0.08, 1.38)]. The MT, CBT, and IPT ranked in the top three in alleviating anxiety, while IPT, CBT, and MT ranked in the top three in alleviating depression. CONCLUSION MT and IPT would be a more appropriate option in alleviating anxiety and depression in patients with cancer, respectively. This study also suggested that CBT had a significant effect in alleviating negative emotions in patients with cancer. However, the results need to be validated by high-quality and large-sample studies.
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Affiliation(s)
- Yinhao Yang
- School of Nursing, Hubei University of Medicine, Shiyan, China
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
| | - Yingying Yi
- School of Nursing, Hubei University of Medicine, Shiyan, China
| | - Xixi Shi
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
| | - Xueqin Yang
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
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Li M, Zhang L, Li N, Luo X, Chen J, Zhang Y, Xiong C, Zhao M, Guo Z, Yan J. Effects of couple-based dyadic interventions on breast cancer patients and their intimate partners: A systematic review and meta-analysis. J Adv Nurs 2023; 79:3192-3213. [PMID: 36918983 DOI: 10.1111/jan.15639] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/17/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023]
Abstract
AIMS To evaluate the effects of couple-based dyadic interventions on breast cancer patients and their intimate partners and compare the effects between interventions with different durations (<3 months; =3 months; >3 months). DESIGN A systematic review and meta-analysis. DATA SOURCES Six English databases, PubMed, Embase, Web of Science Core Collection, the Cochrane Library, Medline, PsycINFO, and three Chinese databases, China National Knowledge Infrastructure (CNKI), WanFang, and Weipu (VIP), from database inception to 19 February 2022. REVIEW METHODS The quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool and the data analysis was performed by using RevMan 5.4 and Stata 15. The outcomes were categorized into five aspects: dyadic relationship, overall quality of life (QOL), physical health, psychological health and social adjustment. RESULTS Nineteen RCTs were included. For patients' overall effects, couple-based dyadic interventions can improve sexual frequency, psychological health (anxiety; depression; well-being; body image) and social adjustment (family function-cohesion; social function-total). In the subgroup analysis, it can adjust patients' relationship satisfaction (>3 months), sexual frequency (>3 months), depression (<3 months and >3 months), well-being (>3 months), and body image (3 months). For intimate partners, no statistically significant overall effects were found, and all results in the subgroup analyses showed no statistical significance. CONCLUSIONS The results revealed the different effects of couple-based dyadic interventions on dyads. It also suggested that tailored intervention duration should be a focus in future studies to obtain the potential actor-partner benefits. IMPACT This study revealed that the overall effects of the couple-based dyadic interventions include enhancing patients' sexual frequency, psychological health and social adjustment. Clinical practitioners should consider the intimate partners' outcomes and conduct couple-based dyadic interventions that contain more tailored elements to achieve better effects. NO PATIENT OR PUBLIC CONTRIBUTION Registration: The systematic review and meta-analysis of RCTs has been registered in PROSPERO (Number: CRD 42021286679).
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Affiliation(s)
- Mingfang Li
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Lijuan Zhang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Na Li
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Xia Luo
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Jing Chen
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Yue Zhang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Chenxia Xiong
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Meng Zhao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Zijun Guo
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Jun Yan
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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Zhou Y, Che CC, Chong MC, Zhao H, Lu Y. Effects of marital self-disclosure on marital relationship and psychological outcome for cancer patients: a systematic review. Support Care Cancer 2023; 31:361. [PMID: 37249639 DOI: 10.1007/s00520-023-07826-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/21/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses. METHOD This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. RESULTS Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability. CONCLUSION The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions' long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.
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Affiliation(s)
- Ye Zhou
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Haiyan Zhao
- Nursing Department, Jingjiang People's Hospital, Taizhou City, Jiangsu Province, China
| | - Yin Lu
- Nursing Department, Jingjiang People's Hospital, Taizhou City, Jiangsu Province, China
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Li M, Chan CWH, Chan D, Li X, Zhang M, Zhang H, Feng L, Huang L, Mielke R, Du J. The effectiveness of WeChat couple-based psychosocial support for gynaecological cancer: A randomised controlled trial. BJOG 2023; 130:599-609. [PMID: 36648406 DOI: 10.1111/1471-0528.17375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of an 8-week electronic couple-based psychosocial support platform (WeChat) for gynaecological cancer. DESIGN Randomised controlled trial. SETTING Oncology hospital in Shaanxi Province, China. PARTICIPANTS A total of 98 dyads of women with gynaecological cancer and their intimate male partners were included. METHODS Couple dyads were randomly allocated to either the WeChat couple-based psychosocial support or to a control group receiving eight WeChat articles on general education content related to diet and exercise. MAIN OUTCOME MEASURES The primary outcome was sexual function assessed with the Female Sexual Function Index. The secondary outcomes of relationship satisfaction and quality of life were assessed with the Chinese version of Revised Dyadic Adjustment Scale, Functional Assessment of Cancer Therapy-General and The World Health Organization Quality of Life BREF. These outcomes were assessed before randomisation, and immediately and 3 months after the intervention. RESULTS The study showed that the sexual function of women participants in the intervention group did not reach a significant level compared with the control group. Relationship satisfaction in the intervention programme improved significantly (adjusted mean difference 4.7, 95% confidence interval [CI] 2.0-7.4; p = 0.001) and quality of life (QoL 6.9, 95% CI 0.5-13.3; p = 0.035) 3 months after the intervention in women with gynaecological cancer. The intervention programme also showed significant positive effects on optimising relationship satisfaction (adjuste mean difference 3.0, 95% CI 0.3-5.7; p = 0.027) of male partners. CONCLUSIONS The results provided additional knowledge and an evidence base for the application of the support programme to improve relationship satisfaction and QoL among couples living with gynaecological cancer.
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Affiliation(s)
- Minjie Li
- Department of Nursing, Shaanxi Provincial People's Hospital, Xi'an, China.,Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Carmen W H Chan
- Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Dorothy Chan
- Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Xiaomei Li
- Department of Nursing, Xi'an Jiaotong University, Xi'an, China
| | - Mengyue Zhang
- Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hui Zhang
- Department of Gynaecological Oncology, Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Li Feng
- Department of Gynaecological Oncology, Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Lina Huang
- Department of Gynaecological Oncology, Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Ruth Mielke
- School of Nursing, Azusa Pacific University, Azusa, California, USA
| | - Juan Du
- School of Nursing, The Fourth Military Medical University, Xi'an, China
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Jassim GA, Doherty S, Whitford DL, Khashan AS. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2023; 1:CD008729. [PMID: 36628983 PMCID: PMC9832339 DOI: 10.1002/14651858.cd008729.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. This review is an update of a Cochrane Review first published in 2015. OBJECTIVES To assess the effect of psychological interventions on psychological morbidities and quality of life among women with non-metastatic breast cancer. SEARCH METHODS: We searched the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov up to 16 March 2021. We also scanned the reference lists of relevant articles. SELECTION CRITERIA Randomised controlled trials that assessed the effectiveness of psychological interventions for women with non-metastatic breast cancer. DATA COLLECTION AND ANALYSIS Two review authors independently appraised, extracted data from eligible trials, and assessed risk of bias and certainty of the evidence using the GRADE approach. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcomes. MAIN RESULTS We included 60 randomised controlled trials comprising 7998 participants. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. The updated review included 7998 randomised women; the original review included 3940 women. A wide range of interventions was evaluated. Most interventions were cognitive- or mindfulness-based, supportive-expressive, and educational. The interventions were mainly delivered face-to-face (56 studies) and in groups (50 studies) rather than individually (10 studies). Most intervention sessions were delivered on a weekly basis with an average duration of 14 hours. Follow-up time ranged from two weeks to 24 months. Pooled standardised mean differences (SMD) from baseline indicated that the intervention may reduce depression (SMD -0.27, 95% confidence interval (CI) -0.52 to -0.02; P = 0.04; 27 studies, 3321 participants, I2 = 91%, low-certainty evidence); anxiety (SMD -0.43, 95% CI -0.68 to -0.17; P = 0.0009; 22 studies, 2702 participants, I2 = 89%, low-certainty evidence); mood disturbance in the intervention group (SMD -0.18, 95% CI -0.31 to -0.04; P = 0.009; 13 studies, 2276 participants, I2 = 56%, low-certainty evidence); and stress (SMD -0.34, 95% (CI) -0.55 to -0.12; P = 0.002; 8 studies, 564 participants, I2 = 31%, low-certainty evidence). The intervention is likely to improve quality of life in the intervention group (SMD 0.78, 95% (CI) 0.32 to 1.24; P = 0.0008; 20 studies, 1747 participants, I2 = 95%, low-certainty evidence). Adverse events were not reported in any of the included studies. AUTHORS' CONCLUSIONS Based on the available evidence, psychological intervention may have produced favourable effects on psychological outcomes, in particular depression, anxiety, mood disturbance and stress. There was also an improvement in quality of life in the psychological intervention group compared to control group. Overall, there was substantial variation across the studies in the range of psychological interventions used, control conditions, measures of the same outcome and timing of follow-up.
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Affiliation(s)
- Ghufran A Jassim
- Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | - Sally Doherty
- Psychiatry, Royal College of Surgeons in Ireland- Medical University of Bahrain (RCSI Bahrain), Busaiteen, Bahrain
| | | | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
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van Diest SL, den Oudsten BL, Aaronson NK, Beaulen A, Verboon P, Aarnoudse B, van Lankveld JJDM. Emotionally focused couple therapy in cancer survivor couples with marital and sexual problems: a replicated single-case experimental design. Front Psychol 2023; 14:1123821. [PMID: 37205090 PMCID: PMC10187887 DOI: 10.3389/fpsyg.2023.1123821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/03/2023] [Indexed: 05/21/2023] Open
Abstract
Objective The current research examined the effect of Emotionally Focused Couples Therapy (EFCT) on perceived intimacy, affect, and dyadic connection in cancer survivor couples with relationship challenges. Method In this longitudinal replicated single-case study, positive and negative affect, intimacy, partner responsiveness, and expression of attachment-based emotional needs were reported every 3 days before and during treatment. Thirteen couples, with one partner having survived colorectal cancer or breast cancer, participated for the full duration of the study. Statistical analysis of the data was performed using randomization tests, piecewise regression, and multilevel analyses. Results Adherence to the therapeutic protocol was tested and found adequate. Compared with baseline, significant positive effects on affect variables were found during the therapeutic process. Positive affect increased and negative affect decreased. Partner responsiveness, perceived intimacy, and the expression of attachment-based emotional needs improved, but only in the later phase of treatment. Results at the group level were statistically significant, whereas effects at the individual level were not. Discussion This study found positive group-level effects of EFCT on affect and dyadic outcome measures in cancer survivors. The positive results warrant further research, including randomized clinical trials, to replicate these effects of EFCT in cancer survivor couples experiencing marital and sexual problems.
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Affiliation(s)
- Selma L. van Diest
- Department of Clinical Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Brenda L. den Oudsten
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Neil K. Aaronson
- Department of Psychosocial Research, University of Amsterdam, Amsterdam, Netherlands
| | - Audrey Beaulen
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Peter Verboon
- Department of Methodology and Statistics, Open University of the Netherlands, Heerlen, Netherlands
| | | | - Jacques J. D. M. van Lankveld
- Department of Clinical Psychology, Open University of the Netherlands, Heerlen, Netherlands
- *Correspondence: Jacques J. D. M. van Lankveld,
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Ma'rifah AR, Afiyanti Y, Huda MH, Chipojola R, Putri YR, Nasution MAT. Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2022; 30:8271-8285. [PMID: 35821448 DOI: 10.1007/s00520-022-07277-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/03/2022] [Indexed: 12/24/2022]
Abstract
Psychoeducation interventions have been suggested to improve sexual functioning and quality of life. The aim of this study was to examine the effects of the psychoeducation intervention on quality of life, sexual function, and psychological outcomes; and to identify the critical components of psychoeducation intervention for women with gynecological cancer. This study was a systematic review and meta-analysis. Psychoeducation interventions were searched using six English databases, eligible studies were extracted, and the risk of bias was evaluated by two authors independently. A random effects model was used to examine the intervention effects. We conducted subgroup analysis and meta-regression to assess the variables underlying the heterogeneity. In total, eight trials were identified, and 1128 participants were included. Women who received the psychoeducation intervention had better quality of life (standardized mean difference (SMD) = 0.59, 95% confidence interval (CI): 0.22, 0.97), sexual functioning (SMD = 0.63, 95% CI: 0.27, 0.99), and psychological outcomes (i.e., anxiety and depression (SMD = - 0.27, 95% CI: - 0.09, - 0.44)). Interventions that combined lecture-based, skill practical, discussion, and counseling were conducted using an online format and were delivered by a team of health professionals that had higher scores of qualities of life. Additionally, involving significant others in the intervention improved sexual functioning. Psychoeducation interventions effectively improve quality of life, sexual functioning, anxiety, and depression. Incorporating lecture-based, practical skills, discussion, and counseling through an online format and involving significant others are beneficial for improving the quality of life and sexual functioning among women with gynecological cancer.
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Affiliation(s)
- Atun Raudotul Ma'rifah
- Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424.,Harapan Bangsa University Purwokerto, Jl. Raden Patah no 100 Ledug Kembaran Banyumas, Central Java, Indonesia
| | - Yati Afiyanti
- Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424.
| | - Mega Hasanul Huda
- Institute Kesehatan Prima Nusantara Bukit Tinggi, Hermina Hospital Group, Gn. Sahari Sel, Jl. Selangit, RW.10, Kec. Kemayoran, Central Jakarta, Capital Region of Jakarta, Indonesia, 10620
| | | | - Yelmi Reni Putri
- Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424.,Fort De Kock University, Jl. Soekarno Hatta No. 11, Manggis Ganting, Mandingin, Kota Selayan-Kota Bukit Tinggi West Sumatra, Indonesia
| | - M A Tantawi Nasution
- National Library of the Republik of Indonesia, Salemba Raya, 28 A. Kenari, Senen, Central Jakarta, Capital Region of Jakarta, Indonesia
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Sak-Dankosky N, Sherwood P, Vehviläinen-Julkunen K, Kvist T. Interventions improving well-being of adult cancer patients' caregivers: A systematic review. J Adv Nurs 2022; 78:2747-2764. [PMID: 35696332 DOI: 10.1111/jan.15320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 03/23/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to determine what kind of psychosocial interventions aimed at improving the well-being of adult cancer patient caregivers were developed, and to describe the methodological characteristics and clinical effectiveness of the interventions which could be included in the nursing care plans. DESIGN Systematic review DATA SOURCES: A systematic search of three databases (PubMed, CINAHL, and PsycINFO) was conducted to identify peer-reviewed papers published between years 2004-2019. REVIEW METHODS The review was guided by the Joanna Briggs Institute manual for systematic reviews. Data were extracted and appraised by three reviewers using standardized checklists. Narrative synthesis was used to analyse the data. RESULTS A total of 37 studies underwent analysis. Most of the studies described psychoeducational interventions, designed for patient-caregiver dyads, delivered face-to-face. There was a great variety in caregiver outcomes and measurement tools used. Even though most studies used a randomized controlled design and standardized intervention protocols, many reported problems with recruitment and attrition. Most studies reported that the intervention improved caregiver outcomes, yet the majority of them failed to report effect sizes. CONCLUSION There are currently a plethora of successful interventions available for cancer patient caregivers which can be included to the nursing care plan. Psychoeducational online interventions which include a social support component may have the best potential in supporting caregivers. It is important to address specific caregiver needs at different cancer stages rather than general needs of caregivers in future interventions. IMPACT This review suggests that despite a large number of different interventions which can be included in the nursing care plan to improve the support offered to caregivers, some issues should be addressed while designing an intervention study. The emphasis should be placed on reporting effect sizes, focusing on specific caregiver needs and improving recruitment, retention strategies and sustainability of caregiver interventions.
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Affiliation(s)
| | - Paula Sherwood
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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9
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Hasson-Ohayon I, Goldzweig G, Braun M, Hagedoorn M. Beyond "being open about it": A systematic review on cancer related communication within couples. Clin Psychol Rev 2022; 96:102176. [PMID: 35700574 DOI: 10.1016/j.cpr.2022.102176] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
Abstract
Extensive literature addresses the correlates of communication behaviors within couples in the specific stressful context of oncology. This literature focused mainly on the concepts of disclosure, concealment, holding back and protective buffering to gain more insight into the potential benefits of open communication on the psychological and relational wellbeing of the patient, the spouse and the dyad. The current systematic review aims to present this literature, summarize research findings and suggest empirical, theoretical and clinical implications. Methods: The search method applied in this review was in line with the PRISMA guidelines. Key words related to couples' communication and oncology were used to identify relevant studies according to title and abstract fields from 1.1.2000 until 31.1.22. Results: Out of 3277 papers, a total of 55 articles were identified as relevant for this review. These quantitative studies used cross-sectional and longitudinal designs. Overall, integrating findings from different studies showed that while avoiding communication is negatively associated with psychological and relational wellbeing, the benefits of disclosure seems to be dependent on different factors including the partner's responsiveness, contextual factors and personal characteristics. The existing literature is limited in providing data regarding the nature of adequate or helpful partner responses, the best timing, and the specific topics that are recommended to be disclosed such as specific fears. Most importantly, it is limited in heterogeneity of constructs of communication that were studied, scales that were used and diverse mediators and moderators that were examined. Accordingly, an effort to reach consensus of definition and assessment of communicative behavior is recommended for future studies, and addressing responsiveness to communicative initiations seems to be important for clinical practice.
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Affiliation(s)
| | | | | | - Mariët Hagedoorn
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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10
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Xu J, Xue B, Li L, Qiao J, Redding SR, Ouyang YQ. Psychological interventions for sexual function and satisfaction of women with breast cancer: A systematic review and meta-analysis. J Clin Nurs 2022; 32:2282-2297. [PMID: 34985158 DOI: 10.1111/jocn.16194] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To systematically evaluate the effectiveness of psychological interventions for women with breast cancer on sexual function, sexual satisfaction, sexual relationships, sexual distress and sexual quality of life. BACKGROUND Sexual dysfunction is common in women with breast cancer and seriously affects their quality of life and marital harmony. Several studies have explored the effects of psychological interventions related to sexual function of women with breast cancer, but results were inconclusive. DESIGN A systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHOD A search of PubMed, EMBASE, PsycINFO, Web of Science, the Cochrane Library, Scopus, CINAHL, ProQuest Dissertations and Theses Global, ClinicalTrials.gov. and Open Grey was conducted from inception to 9 May 2021. Two reviewers independently screened studies, extracted data and conducted a quality appraisal of included studies using the Joanna Briggs Institute critical appraisal checklists. RESULTS Fifteen studies involving 1307 participants were included. The current study showed that psychological interventions made statistically significant improvements in sexual function (SMD = 0.82; 95% CI = [0.43, 1.20]; p < .001), sexual satisfaction (SMD = 0.95; 95% CI = [0.19, 1.72]; p = .01), sexual relationships (SMD = 0.37; 95% CI = [0.15, 0.60]; p = .001) and sexual distress (MD = -5.05; 95% CI = [-7.88, -2.22]; p = .0005) of women with breast cancer. A subgroup analysis regarding the types of psychological interventions indicated that cognitive behavioural therapy and psychoeducational therapy were beneficial to sexual function and satisfaction, and psychosexual counselling could also improve sexual function. CONCLUSION Psychological interventions, especially psychoeducational therapy and cognitive behavioural therapy, are effective for improving the sexual health of women with breast cancer. RELEVANCE TO CLINICAL PRACTICE This current study provides evidence for the application of psychosexual interventions in women with breast cancer. REGISTRATION The study has been registered on the PROSPERO on 6 June 2021, with the registration number CRD42021253493.
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Affiliation(s)
- Jing Xu
- School of Nursing, Wuhan University, Wuhan, China
| | - Bing Xue
- School of Nursing, Wuhan University, Wuhan, China
| | - Lu Li
- School of Nursing, Wuhan University, Wuhan, China
| | - Jia Qiao
- School of Nursing, Wuhan University, Wuhan, China
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11
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Lamson AL, Hodgson JL, Pratt KJ, Mendenhall TJ, Wong AG, Sesemann EM, Brown BJ, Taylor ES, Williams-Reade JM, Blocker DJ, Harsh Caspari J, Zubatsky M, Martin MP. Couple and family interventions for high mortality health conditions: A strategic review (2010-2019). JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:307-345. [PMID: 34741539 DOI: 10.1111/jmft.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
The earliest publications in the field of marriage and family therapy introduced interventions conducted with families experiencing complex health conditions. This strategic review captures an evaluation of efficacy for 87 couple and family interventions published between 2010 and 2019 with a focus on the leading causes of mortality in the United States. These health conditions include chromosomal anomalies and accidents with infants aged 0-4 years; accidents and cancer among children aged 5-14; accidents among adolescents aged 15-24; and heart disease, cancer, accidents, chronic lower respiratory diseases, stroke, Alzheimer's disease, diabetes, influenza/pneumonia, and nephritis/nephrosis among adults 25 and older. Results support the need for greater inclusion of couples and families in assessments and interventions. The greatest chasm in efficacy research was with minoritized couples and families. Implications include ways to initiate couple and family interventions in the context of health conditions with attention given to accessibility, recruitment, retention, and evaluation.
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Affiliation(s)
- Angela L Lamson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Jennifer L Hodgson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Keeley J Pratt
- Department of Human Services, Human Development and Family Science Program, Couple and Family Therapy Specialization, College of Education & Human Ecology, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Tai J Mendenhall
- Department of Family Social Science, University of Minnesota, Saint Paul, Minnesota, USA
| | - Alison G Wong
- Department of Marriage and Family Therapy, Fuller School of Psychology and Marriage and Family Therapy, Pasadena, California, USA
| | | | - Braden J Brown
- Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Athletics Department, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Erika S Taylor
- Department of Family Medicine, Behavioral Medicine Section, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | - Daniel J Blocker
- Pomona Valley Family Medicine Residency, Pomona Valley Hospital Medical Center, Pomona, California, USA
| | - Jennifer Harsh Caspari
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Max Zubatsky
- Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Matthew P Martin
- Doctor of Behavioral Health Program, College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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12
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Fergus K, Ahmad S, Gardner S, Ianakieva I, McLeod D, Stephen J, Carter W, Periera A, Warner E, Panchaud J. Couplelinks online intervention for young couples facing breast cancer: A randomised controlled trial. Psychooncology 2021; 31:512-520. [PMID: 34669239 DOI: 10.1002/pon.5836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/29/2021] [Accepted: 10/01/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Young women with breast cancer and their partners are more distressed than couples who are affected later in life. While dyadic interventions in the context of cancer are promising, there are access barriers, particularly for younger couples. This study evaluated Couplelinks, a professionally facilitated, web-based program designed to help couples improve their conjoint coping. METHOD This randomised controlled trial employed a waitlist control evaluation of the program. Outcomes included dyadic coping, relationship adjustment, depression, and anxiety. RESULTS Seventy-five couples consented to participate and were randomised. The final analysis included 31 couples in the treatment group and 36 couples in the waitlist group. Modest improvements were found in positive dyadic coping but effects were not maintained at 3-month follow-up. No effect was seen on overall relationship adjustment. CONCLUSIONS Our findings inform the rapidly expanding field of online programming for couples in general, and those affected by BC in particular. Intervention timing, 'dose', low overall relational distress, and the mainly enrichment rather than problem-focus of Couplelinks may help explain the lack of change on relationship adjustment.
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Affiliation(s)
- Karen Fergus
- Department of Psychology, York University, Toronto, Ontario, Canada.,Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Saunia Ahmad
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Toronto Psychology Clinic, Toronto, Ontario, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Iana Ianakieva
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Deborah McLeod
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joanne Stephen
- Clinical Neurosciences, Alberta Health Services, Calgary, Alberta, Canada
| | - Wendy Carter
- Toronto Academic Pain Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Amanda Periera
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Ellen Warner
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jim Panchaud
- Campus Ministry, King's University College, London, Ontario, Canada
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13
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Song L, Qan'ir Y, Guan T, Guo P, Xu S, Jung A, Idiagbonya E, Song F, Kent EE. The Challenges of Enrollment and Retention: A Systematic Review of Psychosocial Behavioral Interventions for Patients With Cancer and Their Family Caregivers. J Pain Symptom Manage 2021; 62:e279-e304. [PMID: 33933618 PMCID: PMC8419067 DOI: 10.1016/j.jpainsymman.2021.04.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
CONTEXT Psychosocial behavioral interventions (PBIs) that target patients with cancer and their caregivers face challenges in participant enrollment and retention. OBJECTIVES 1) Describe characteristics of the patient-caregiver PBI studies; 2) examine participant enrollment and retention rates; 3) identify factors influencing participant enrollment and retention rates; and 4) explore the strategies to promote enrollment and retention rates. METHODS We identified randomized controlled trials that tested PBIs among adult patients with cancer and caregivers in five electronic databases. We conducted narrative and quantitative analyses to synthesize our findings. RESULTS Among 55 qualified studies reviewed, most tested the efficacy of PBIs (n = 42) and used two study arms (n = 48). In-person meeting was the most common PBI delivery mode. The primary outcomes included quality of life, physical health, and symptoms. The average of enrollment rates of patient-caregiver dyads was 33% across studies (range 8%-100%; median = 23%). The average retention rate at the end of follow-ups was 69% (range 16%-100%; median = 70%). The number of study arms, recruitment method, type of patient-caregiver relationship, and intervention duration influenced enrollment rates. Study design (efficacy vs. pilot), follow-up duration, mode of delivery, type of relationship, and intervention duration influenced retention rates. Sixteen studies reported retention strategies, including providing money/gift cards upon study completion and/or after follow-up survey, and excluding patients with advanced cancer. CONCLUSION Researchers need to incorporate effective strategies to optimize enrollment and retention in patient-caregiver PBI trials. Researchers need to report detailed study processes and PBI information to improve research transparency and increase consistency.
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Affiliation(s)
- Lixin Song
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA; University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
| | - Yousef Qan'ir
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA
| | - Ting Guan
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, North Carolina, USA
| | - Peiran Guo
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA
| | - Shenmeng Xu
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA
| | - Ahrang Jung
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA
| | - Eno Idiagbonya
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA
| | - Fengyu Song
- West Coast University, General Education, Anaheim, California, USA
| | - Erin Elizabeth Kent
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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14
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Li M, Chan CWH, Chow KM, Xiao J, Choi KC. A systematic review and meta-analysis of couple-based intervention on sexuality and the quality of life of cancer patients and their partners. Support Care Cancer 2019; 28:1607-1630. [PMID: 31872299 DOI: 10.1007/s00520-019-05215-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/26/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE To synthesize the characteristics and effects of couple-based intervention on sexuality and the quality of life (QOL) of cancer patients and their intimate partners and its implications for future research and practice. METHODS A systematic review and meta-analysis of randomized and non-randomized controlled studies of interventions was conducted in nine English databases and two Chinese databases, with identification of related studies published in English and Chinese. The quality of the studies was assessed using the tools of the Effective Public Health Practice Project. RESULTS A total of 33 articles were identified for systematic review and 23 articles were identified for meta-analysis. For patients, the effect size was 0.42 (Hedges's g, 95% CI = 0.05-0.78, p = 0.03) for physical health. For partners, the effect size was 0.52 (Hedges's g, 95% CI = 0.06-0.98, p = 0.03) for sexual relationships. However, moderate to high heterogeneity was reported. Effects on sexual function, sexual self-concept, and mental health for couples were not significant. CONCLUSION Couple-based interventions had small to medium-sized effects on physical health for cancer patients. Partners could derive medium effects for improvement in sexual relationships from couple-based intervention. Future research should pay more attention to sexual self-concept in cancer patients and target types of cancer that are more likely to compromise sexuality and QOL. PROSPERO REGISTRATION The systematic review and meta-analysis has been registered in PROSPERO with registration number: CRD42019119047.
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Affiliation(s)
- Minjie Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jinnan Xiao
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
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15
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Brandl A, Katou S, Pallauf A, Pratschke J, Rau B, Goerling U. Psycho-oncological distress in patients with peritoneal surface malignancies treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur Surg 2019. [DOI: 10.1007/s10353-019-00614-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Treanor CJ, Santin O, Prue G, Coleman H, Cardwell CR, O'Halloran P, Donnelly M. Psychosocial interventions for informal caregivers of people living with cancer. Cochrane Database Syst Rev 2019; 6:CD009912. [PMID: 31204791 PMCID: PMC6573123 DOI: 10.1002/14651858.cd009912.pub2] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Increasingly, cancer is recognised as a chronic condition with a growing population of informal caregivers providing care for cancer patients. Informal caregiving can negatively affect the health and well-being of caregivers. We need a synthesised account of best evidence to aid decision-making about effective ways to support caregivers for individuals 'living with cancer'. OBJECTIVES To assess the effectiveness of psychosocial interventions designed to improve the quality of life (QoL), physical health and well-being of informal caregivers of people living with cancer compared with usual care. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, ProQuest, Open SIGLE, Web of Science from inception up to January 2018, trial registries and citation lists of included studies. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials comparing psychosocial interventions delivered to adult informal caregivers of adults affected by cancer on a group or individual basis with usual care. Psychosocial interventions included non-pharmacological interventions that involved an interpersonal relationship between caregivers and healthcare professionals. We included interventions delivered also to caregiver-patient dyads. Interventions delivered to caregivers of individuals receiving palliative or inpatient care were excluded. Our primary outcome was caregiver QoL. Secondary outcomes included patient QoL, caregiver and patient depression, anxiety, psychological distress, physical health status and intervention satisfaction and adverse effects. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened studies for eligibility, extracted data and conducted 'Risk of bias' assessments. We synthesised findings using meta-analysis, where possible, and reported remaining results in a narrative synthesis. MAIN RESULTS Nineteen trials (n = 3, 725) were included in the review. All trials were reported in English and were undertaken in high-income countries. Trials targeted caregivers of patients affected by a number of cancers spanning newly diagnosed patients, patients awaiting treatment, patients who were being treated currently and individuals post-treatment. Most trials delivered interventions to caregiver-patient dyads (predominantly spousal dyads) and there was variation in intervention delivery to groups or individual participants. There was much heterogeneity across interventions though the majority were defined as psycho-educational. All trials were rated as being at 'high risk of bias'.Compared to usual care, psychosocial interventions may improve slightly caregiver QoL immediately post intervention (standardised mean difference (SMD) 0.29, 95% confidence interval (CI) 0.04 to 0.53; studies = 2, 265 participants) and may have little to no effect on caregiver QoL at 12 months (SMD 0.14, 95% CI - 0.11 to 0.40; studies = 2, 239 participants) post-intervention (both low-quality evidence).Psychosocial interventions probably have little to no effect on caregiver depression immediately to one-month post-intervention (SMD 0.01, 95% CI -0.14 to 0.15; studies = 9, 702 participants) (moderate-quality evidence). Psychosocial interventions may have little to no effect on caregiver anxiety immediately post-intervention (SMD -0.12, 95 % CI -0.33 to 0.10; studies = 5, 329 participants), depression three-to-six months (SMD 0.03, 95% CI -0.33 to 0.38; studies = 5. 379 participants) post-intervention and patient QoL six to 12 months (SMD -0.05, 95% CI -0.37 to 0.26; studies = 3, 294 participants) post-intervention (all low-quality evidence). There was uncertainty whether psychosocial interventions improve patient QoL immediately (SMD -0.03, 95 %CI -0.50 to 0.44; studies = 2, 292 participants) or caregiver anxiety three-to-six months (SMD-0.25, 95% CI -0.64 to 0.13; studies = 4, 272 participants) post-intervention (both very low-quality evidence). Two studies which could not be pooled in a meta-analysis for caregiver physical health status found little to no effect immediately post-intervention and a small intervention effect 12 months post-intervention. Caregiver or patient satisfaction or cost-effectiveness of interventions were not assessed in any studies. Interventions demonstrated good feasibility and acceptability.Psychosocial interventions probably have little to no effect on patient physical health status immediately post-intervention (SMD 0.17, 95 % CI -0.07 to 0.41; studies = 4, 461 participants) and patient depression three to six months post-intervention (SMD-0.11, 95% CI -0.33 to 0.12; studies = 6, 534 participants) (both moderate-quality evidence).Psychosocial interventions may have little to no effect on caregiver psychological distress immediately to one-month (SMD -0.08, 95% CI -0.42 to 0.26; studies = 3, 134 participants), and seven to 12 months (SMD 0.08, 95% CI -0.42 to 0.58; studies = 2, 62 participants) post-intervention; patient depression immediately (SMD -0.12, 95% CI -0.31 to 0.07; studies = 9, 852 participants); anxiety immediately (SMD -0.13, 95% CI -0.41 to 0.15;studies = 4, 422 participants), and three to six months (SMD -0.22, 95% CI -0.45 to 0.02; studies = 4, 370 participants); psychological distress immediately (SMD -0.02, 95% CI -0.47 to 0.44; studies = 2, 74 participants) and seven to 12 months (SMD -0.27, 95% CI -0.78 to 0.24; studies = 2, 61 participants); and physical health status six to 12 months (SMD 0.06, 95% CI -0.18 to 0.30; studies = 2, 275 participants) post-intervention (all low-quality evidence).Three trials reported adverse effects associated with the interventions, compared with usual care, including higher distress, sexual function-related distress and lower relationship satisfaction levels for caregivers, higher distress levels for patients, and that some content was perceived as insensitive to some participants.Trials not able to be pooled in a meta-analysis did not tend to report effect size and it was difficult to discern intervention effectiveness. Variable intervention effects were reported for patient and caregiver outcomes. AUTHORS' CONCLUSIONS Heterogeneity across studies makes it difficult to draw firm conclusions regarding the effectiveness of psychosocial interventions for this population. There is an immediate need for rigorous trials with process evaluations and clearer, detailed intervention descriptions. Cost-effectiveness studies should be conducted alongside future trials.
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Affiliation(s)
- Charlene J Treanor
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Olinda Santin
- Queen's University BelfastSchool of Nursing and Midwifery97 Lisburn RoadBelfastUKBT9 7BL
| | - Gillian Prue
- Queen's University BelfastSchool of Nursing and Midwifery97 Lisburn RoadBelfastUKBT9 7BL
| | - Helen Coleman
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Chris R Cardwell
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Peter O'Halloran
- Queen's University BelfastSchool of Nursing and Midwifery97 Lisburn RoadBelfastUKBT9 7BL
| | - Michael Donnelly
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
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17
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Nicolaisen A, Hagedoorn M, Hansen DG, Flyger HL, Christensen R, Rottmann N, Lunn PB, Terp H, Soee K, Johansen C. The effect of an attachment-oriented couple intervention for breast cancer patients and partners in the early treatment phase: A randomised controlled trial. Psychooncology 2018; 27:922-928. [PMID: 29265672 PMCID: PMC5873374 DOI: 10.1002/pon.4613] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 11/29/2017] [Accepted: 12/04/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Patients and partners both cope individually and as a dyad with challenges related to a breast cancer diagnosis. The objective of this study was to evaluate the effect of a psychological attachment-oriented couple intervention for breast cancer patients and partners in the early treatment phase. METHODS A randomised controlled trial including 198 recently diagnosed breast cancer patients and their partners. Couples were randomised to the Hand in Hand (HiH) intervention in addition to usual care or to usual care only. Self-report assessments were conducted for both patients and partners at baseline, postintervention (5 months), and follow-up (10 months), assessing cancer-related distress, symptoms of anxiety and depression, and dyadic adjustment. Patients' cancer-related distress was the primary outcome. RESULTS Cancer-related distress decreased over time in both patients and partners, but the intervention did not significantly affect this decrease at postintervention (P = .08) or follow-up (P = .71). A significant positive effect was found on dyadic adjustment at follow-up for both patients (P = .04) and partners (P = .02). CONCLUSIONS There was no significant effect of the HiH intervention cancer-related distress. The results suggest that most couples can cope with cancer-related distress in the context of usual care. However, the positive effect on dyadic adjustment implies that the HiH intervention benefitted both patients and partners. Future studies should investigate how to integrate a couple focus in usual cancer care to improve dyadic coping in the early treatment phase.
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Affiliation(s)
- A Nicolaisen
- National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Center for Quality, Region of Southern Denmark, Middelfart, Denmark
| | - M Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D G Hansen
- National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - H L Flyger
- Department of Breast Surgery, Herlev University Hospital, Herlev, Denmark
| | - R Christensen
- National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - N Rottmann
- National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Department of Psychology, University of Southern Denmark, Odense M, Denmark
| | - P B Lunn
- Department of Plastic Surgery and Breast Surgery, Ringsted Hospital, Ringsted, Denmark
| | - H Terp
- National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - K Soee
- Centre for Breast Surgery, Department of Plastic Surgery, Odense University Hospital, Odense, Denmark
| | - C Johansen
- Danish Cancer Society Research Center, Survivorship, Danish Cancer Society, Copenhagen, Denmark.,Oncology Clinic, Finsen Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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