The quality of evidence is downgraded by study limitations (unclear allocation concealment and wide confidence intervals), and for mood measures by inconsistency (unexplained variability of results).
Nurse-led psychosocial interventions are suggested for help seeking patients with newly diagnosed cancer.
A Cochrane review [Abstract] 1 included 30 randomized trials with 5155 participants. The studies had significant variation in type of cancer (breast cancer was the most common with 9 studies), content and administration of the therapy, and the background of the therapist. The results were analyzed in respective subgroups. Fourteen studies specifically referred to Cognitive Behavioural Therapy (CBT), or other recognized techniques, 8 studies defined the intervention as a form of counseling: supportive interaction was present in all of the interventions. The intervention was delivered face to face in 20 studies, by telephone in 4 studies, and by their combination in 6 studies. The number of sessions varied for 1 to 10.The training of the intervention provider was: nurses 11 studies, psychologists in 5, medical practitioners in 4, and multidisciplinary teams in four of the studies. The control was defined as ‘standard care and information'.
Psychosocial interventions compared to standard care did not have a statistically significant effect on overall quality of life (SMD 0.11; 95% CI 0.00 to 0.22) or general psychological distress. A small positive effect was observed in the outcomes of cancer-related QoL (9 studies, SMD 0.16, CI 0.02 to 0.30) and mood (8 studies, SMD -0.81, CI -1.44 to-0.08, with significant heterogeneity. Psychoeducational interventions (1 study) and nurse-delivered interventions using face-to-face and telephone delivery (2 studies) indicated the most promising results. Of the trials not included in the meta-analysis, 7 out of 10 showed a statistically significant positive result.
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