by ecancer reporter Janet Fricker

Nurse-delivered psychosocial interventions could provide valuable improvements in illness specific quality of life (QoL) for cancer patients, finds a Cochrane Review.

The authors, however, conclude that there is not enough evidence to support universal application of psychosocial interventions to all cancer patients.

It is well recognised that a diagnosis of cancer can be emotionally challenging for patients and lead to significant psychological distress in up to 70% of cases.

UK government policy recommends that all individuals diagnosed with cancer should be assessed for emotional problems and given access to appropriate psychological support services.

There is, however, a lack of ‘clarity’ about the most effective approach to addressing psychological distress.

For the current meta-analysis, the Cochrane team searched the Cochrane Central Register of Controlled Trials, Medline, EMBASE, and PsycINFO for studies up to January 2011 to identify randomised controlled trials of psychosocial interventions involving interpersonal dialogue between trained helpers and newly diagnosed cancer patients.

For the study a psychosocial interventions was defined as non pharmacological and involving interpersonal relationships between a patient or group of patients and one or more trained (usually professional) helpers.

Altogether the team identified 30 trials for the review, involving research data from 1249 patients who had taken part in randomised controlled trials where psychosocial interventions involving interpersonal dialogue were compared with standard care only. The trials measured QoL, general psychological distress, anxiety and depression.

Results showed that the most common discipline to administer psychosocial interventions with newly diagnosed patients were registered nurses (11 trials). In a further four studies interventions were administered by multidisciplinary teams of social workers, psychologists and nurses.

Results at the macro level showed that there was no clear evidence of benefit for providing  psychosocial interventions to improve QoL (SMD 0.11; 95% CI 0.00 to 0.22). However, on subgroup analysis nurse delivered interventions appeared to show promise in producing a positive impact on QoL (SMD 0.23; 95%CI 0.04 to 0.43).

“The findings indicate that, to date, there is a lack of convincing evidence to support universal implementation of individual therapeutic psychosocial interventions that are designed to improve the general QoL of newly diagnosed cancer patients,” write the authors. The fact that nurse-delivered interventions appear to show promise in producing a positive impact on QoL, they add, may due to the fact that nursing staff can offer psychological support as part of a package of cancer care, allowing patients to avoid any perceived stigma attached to seeking additional help for emotional concerns.

“Risk screening is required to identify and target patients who are at most risk of emotional difficulties and, therefore, most in need of support, along with consideration of a range of possible interventions types to suit identified need,” write the authors.

Reference

Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients (Review) Galway K, Black A, Cantwell M, Cardwell CR, Mills M, Donnelly M. Published in The Cochrane Library 2012, Issue 12.