Do Psychosocial Interventions Improve Quality of Life After a Cancer Diagnosis?

Nurse-delivered interventions that combined psychoeducation with supportive attention may help improve mood in patients in whom cancer has been newly diagnosed, according to an intervention review and meta-analysis conducted by the Cochrane Gynaecological Cancer Group.¹

Up to 75% of patients in whom cancer has been newly diagnosed experience significant psychological distress, but which psychosocial interventions most effectively improve quality of life (QoL) and general distress are unknown. To better understand the effects of psychosocial interventions in the first year after a cancer diagnosis, researchers identified randomized controlled trials of psychosocial interventions that measured QoL and general psychological distress in newly diagnosed cancer patients. These psychosocial interventions involved personal dialogue between a “trained helper” and the patient. Trials that involved interventions that included any form of pharmacological treatment or participants other than the patient were excluded.

A total of 30 trials were included in the review, and data from 1249 trial participants were used in various analyses. In the analysis of QoL, which included 9 studies, no significant improvements were noted at the 6-month follow up. A small improvement in QoL was noted when QoL measurements included cancer-specific measures, however. General psychological distress, when assessed by “mood measures,” also was found to improve.¹ When measures of anxiety or depression were used to measure distress, however, no significant effect was found. Breast cancer patients who received psychoeducational and other interventions administered by nurses either face to face or by telephone had small but significant improvements in QoL.

Although no overall improvements in general quality of life, anxiety, or depression were found, small improvements were observed for illness-related quality of life and mood. These results must be considered inconclusive, but the review authors write that there is enough evidence to tentatively conclude that “nurse-delivered interventions comprising information combined with supportive attention may have a beneficial impact on mood in an undifferentiated population of newly diagnosed cancer patients.”¹

The review authors suggest that future research should focus on identifying which patients may benefit from psychosocial interventions, determining who is the most appropriate professional to delivery these interventions to cancer patients, and assessing the cost-effectiveness of psychosocial interventions in this patient population.¹ The need for psychosocial support of cancer patients throughout all stages of the disease, however, remains important.²

Pertinent Points:
- Small improvements in quality of life and general psychological distress occurred when nurse-delivered interventions involving psychoeducation and supportive attention were administered to newly diagnosed cancer patients.
- Despite these small benefits, the effectiveness of psychosocial interventions for cancer patients remains inconclusive.

References:

1. Galway K, Black A, Cantwell M, et al. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev. 2012;11:CD007064. DOI: 10.1002/14651858.CD007064.pub2.
2. Stanton AL. Psychosocial concerns and interventions for cancer survivors. J Clin Oncol. 2006;24:5132-5137.