Evidence for interventions to improve psychological outcomes in people with head and neck cancer: A systematic review of the literature

Luckett, T; Britton, B; Clover, K; Rankin, NM

Evidence for interventions to improve psychological outcomes in people with head and neck cancer: A systematic review of the literature

Luckett, T

Britton, B Clover, K Rankin, NM

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Publication Type:: Journal Article
Citation:: Supportive Care in Cancer, 2011, 19 (7), pp. 871 - 881
Issue Date:: 2011-07-01

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Field	Value	Language
dc.contributor.author	Luckett, T https://orcid.org/0000-0001-6121-5409	en_US
dc.contributor.author	Britton, B	en_US
dc.contributor.author	Clover, K	en_US
dc.contributor.author	Rankin, NM	en_US
dc.date.available	2011-02-13	en_US
dc.date.issued	2011-07-01	en_US
dc.identifier.citation	Supportive Care in Cancer, 2011, 19 (7), pp. 871 - 881	en_US
dc.identifier.issn	0941-4355	en_US
dc.identifier.uri	http://hdl.handle.net/10453/31270
dc.description.abstract	Purpose In addition to cancer-related distress, people with head and neck cancer (HNC) endure facial disfigurement and difficulties with eating and communication. High rates of alcohol use and socio-economic disadvantage raise concerns that patients with HNC may be less likely than others to participate in and adhere to psychological interventions. This article aims to inform future practice and research by reviewing the evidence in support of psychological interventions for this patient group. Methods We searched CENTRAL, Medline, Embase, PsycINFO and CINAHL in December 2009. Relevant studies were rated for internal and external validity against the criteria of the Agency for Healthcare Research and Quality (AHRQ) US Preventive Services Task Force. Wherever possible, outcomes were evaluated using effect sizes to confirm statistically significant results and enable comparison between studies. Meta-analysiswas planned according to criteria in the Cochrane Handbook for Systematic Reviews. Levels of evidence for each intervention type were evaluated using AHRQ criteria. Results Nine studies met inclusion criteria. One study was rated 'good' for internal validity and four for external validity. Psycho-education and/or cognitive behavioural therapy were evaluated by seven studies, and communication skills training and a support group by one study each. Significant heterogeneity precluded meta-analysis. Based on a study-by-study review, there was most support for psycho-education, with three out of five studies finding at least some effect. Conclusions Research to date suggests it is feasible to recruit people with HNC to psychological interventions and to evaluate their progress through repeated-outcome measures. Evidence for interventions is limited by the small number of studies, methodological problems, and poor comparability. Future interventions should target HNC patients who screen positive for clinical distress and be integrated into standard care. © 2011 Springer-Verlag.	en_US
dc.relation.ispartof	Supportive Care in Cancer	en_US
dc.relation.isbasedon	10.1007/s00520-011-1119-7	en_US
dc.subject.classification	Oncology & Carcinogenesis	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Head and Neck Neoplasms	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Adaptation, Psychological	en_US
dc.subject.mesh	Depression	en_US
dc.subject.mesh	Stress, Psychological	en_US
dc.subject.mesh	Anxiety	en_US
dc.subject.mesh	Interview, Psychological	en_US
dc.subject.mesh	Psychometrics	en_US
dc.subject.mesh	Evidence-Based Medicine	en_US
dc.subject.mesh	Quality of Life	en_US
dc.title	Evidence for interventions to improve psychological outcomes in people with head and neck cancer: A systematic review of the literature	en_US
dc.type	Journal Article
utslib.citation.volume	7	en_US
utslib.citation.volume	19	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	7	en_US
pubs.publication-status	Published	en_US
pubs.volume	19	en_US

Abstract:

Purpose In addition to cancer-related distress, people with head and neck cancer (HNC) endure facial disfigurement and difficulties with eating and communication. High rates of alcohol use and socio-economic disadvantage raise concerns that patients with HNC may be less likely than others to participate in and adhere to psychological interventions. This article aims to inform future practice and research by reviewing the evidence in support of psychological interventions for this patient group. Methods We searched CENTRAL, Medline, Embase, PsycINFO and CINAHL in December 2009. Relevant studies were rated for internal and external validity against the criteria of the Agency for Healthcare Research and Quality (AHRQ) US Preventive Services Task Force. Wherever possible, outcomes were evaluated using effect sizes to confirm statistically significant results and enable comparison between studies. Meta-analysiswas planned according to criteria in the Cochrane Handbook for Systematic Reviews. Levels of evidence for each intervention type were evaluated using AHRQ criteria. Results Nine studies met inclusion criteria. One study was rated 'good' for internal validity and four for external validity. Psycho-education and/or cognitive behavioural therapy were evaluated by seven studies, and communication skills training and a support group by one study each. Significant heterogeneity precluded meta-analysis. Based on a study-by-study review, there was most support for psycho-education, with three out of five studies finding at least some effect. Conclusions Research to date suggests it is feasible to recruit people with HNC to psychological interventions and to evaluate their progress through repeated-outcome measures. Evidence for interventions is limited by the small number of studies, methodological problems, and poor comparability. Future interventions should target HNC patients who screen positive for clinical distress and be integrated into standard care. © 2011 Springer-Verlag.

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