Tao, W.W., Jiang, P., Liu, Y., Aungsuroch, Y., & Tao, X.M. (2014). Psycho-oncologic interventions to reduce distress in cancer patients: A meta-analysis of controlled clinical studies published in People's Republic of China. Psycho-Oncology, 24, 269–278. 

DOI Link

Purpose

STUDY PURPOSE: To summarize and analyze the results of controlled studies published in China to assess the effects of psycho-oncologic interventions on distress in patients with cancer 
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, PubMed
 
KEYWORDS: Chinese terms for psychology, distress, anxiety, depression, and terms related to cancer and interventions including training, group therapy, meditation, and music therapy
 
INCLUSION CRITERIA: Randomized, controlled trials and nonrandomized, controlled studies; patients greater than 18 years old

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 1,398
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: The Jadad Scale for Reporting Randomized Controlled Trials was used to determine the risk of bias. Only those studies scoring > 2 on the Jadad scale were included in this meta analysis.

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED = 207 (qualitative synthesis), 31 (meta-analysis)
 
TOTAL PATIENTS INCLUDED IN REVIEW = 3,007 
 
SAMPLE RANGE ACROSS STUDIES: The median sample size was 48 patients.
 
KEY SAMPLE CHARACTERISTICS: Multiple tumor types were included and the median age was 50.85 years. The majority of studies were conducted in women diagnosed with breast cancer.

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

Intervention types that were included in the meta-analysis were educational, psychological support, cognitive behavioral therapy, relaxation training, music therapy, coping skills training, and communication skills training. The majority of studies incorporated two or more interventions together. Fifteen studies showed overall significant effects on anxiety (d = -8.71, p < .001). The combination of education and psychological support (d = -8.17, p = .04) or education combined with relaxation training (d = -12.95, p < .001) were effective in reducing anxiety. Large combined effects were seen on depression (d = -8.12, p < .001). No analysis of effects for specific intervention types was possible. In greater than 69% of studies, the interventions were performed by nurses.

Conclusions

The findings of this study support the effectiveness of psychoeducational interventions to reduce anxiety and depression in patients with cancer in China.

Limitations

The studies included in this analysis had numerous flaws. The meta-analysis was primarily done across all types of interventions. Because most of the studies used combined interventions, the effectiveness of individual components could not be determined. The authors noted that the trials were carried out in Chinese regions where almost no negative studies are reported, so publication bias cannot be ruled out.

Nursing Implications

The findings of these studies support the effectiveness of psychoeducational interventions for anxiety and depression in patients with cancer. Although these findings were only in Chinese patients, they are in agreement with the bulk of overall evidence in this area. These results suggest that psychoeducational interventions are likely to have similar levels of effectiveness in various cultural groups.

Legacy ID

4874