Psychosocial intervention with cancer patients: a review

Watson, Maggie

doi:10.1017/s0033291700051552

Cited by 98 publications

(45 citation statements)

References 27 publications

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“…However, psychosocial intervention is not necessarily total and psychosocial dimension of SIP were lower in beneficial and may even accentuate distress in the than at the 3-month follow-up. Perception by a patient that stresses of adverse events may be beyond control process of trying to change psychological responses [4]. The design of the programme is therefore important.…”

Section: Discussionmentioning

confidence: 99%

“…Many such programmes have been tried in patients the diagnosis, accept recommended treatment and adapt to sequelae of extensive ablative surgery. Even when with cancer [4], individually or in groups, with the type of support possibly determined by the availability of staÂ. apparently cured, diÃculties can arise from stomal or parastomal complications, leakage or diÃculty in emptyAs a rule, the programme is begun immediately after the diagnosis of cancer, to inform on diagnosis, treatment ing urine, and emotional and sexual problems.…”

Section: Introductionmentioning

confidence: 99%

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Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer?

Månsson¹,

Colleen²,

Hermerén

et al. 1997

British Journal of Urology

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Objectives To investigate: (i) if early psychosocial intervention after cystectomy for bladder cancer can assist psychosocial rehabilitation; (ii) if the outcome of such intervention correlates with the patient’s psychological defensive strategies as revealed with the meta‐contrast technique (MCT); and (iii) if the patient’s general philosophical outlook is important in this context. Patients and methods Of 50 patients who had undergone radical cystectomy for bladder cancer, 17 received an ileal conduit, 17 a continent urinary reservoir with abdominal stoma and 16 an orthotopic neobladder. Twenty‐four of the patients were randomized to psychosocial intervention, comprising weekly counselling 4–9 weeks after surgery. All patients were then evaluated with the Sickness‐Impact Profile (SIP) standard questionnaire and the MCT (a projective test of percept‐genetic model) was used to reflect individual defensive strategies at the subconscious or unconscious level. The patient’s general philosophical outlook was recorded before and after surgery. Results There was no significant difference in the results of the SIP between the intervention and the non‐intervention group, as a whole or in its psychosocial dimension. However, intervention benefited patients with continent cutaneous diversion, whose scores on the psychosocial SIP dimension were lower than in the groups with ileal conduit diversion or orthotopic bladder replacement (P<0.05). The MCT analysis of defensive strategies identified three clusters of patients characterized mainly by isolation and repression, repression and stereotypy or sensitivity and stereotypy. Analysis for cluster identification showed no significant SIP score differences between intervention and non‐intervention groups. In an analysis of single defensive strategies, stereotypy was associated with higher total SIP score, but not significantly. Three clusters of philosophical outlook were identified; in one cluster, characterized by a belief in a supernatural power and philosophical interest, the psychosocial SIP scores were lower in the patients who obtained emotional support and the reverse in a cluster with contrary attitudes, although neither differences were significant. Conclusion Psychosocial intervention assisted the psychosocial rehabilitation of patients with continent cutaneous urinary diversion. Defensive strategies and philosophical outlook generally did not influence the outcome of intervention. However, such programmes may be helpful for some patients, mainly those with a basically pessimistic disposition, a general interest in philosophical questions and often using defensive strategies of stereotypy and repression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer?

Månsson¹,

Colleen²,

Hermerén

et al. 1997

British Journal of Urology

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“…Citations in identified papers and reviews (Watson, 1983;Cunningham, 1988;Vachon, 1988;Harman, 1991;Andersen, 1992;Trijsburg et al, 1992), Aslib. index to theses (keywords cancer, counselling and psychotherapy), and Comprehensive Dissertation Abstracts: Psychology (keyword cancer) were manually searched.…”

Section: Search Strategymentioning

confidence: 99%

The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses

Sheard

Maguire²

1999

Br J Cancer

493

332

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Between 15 and 40% of cancer patients develop clinical anxiety and/or depression (Derogatis et al, 1983;Massie and Holland, 1990;Parle et al, 1996). Even for those ostensibly cured the prevalence remains appreciably higher than that of the general population a year or more after diagnosis (Devlen et al, 1987). This evidence, combined with significant pressure from service users, has led to increasing provision of psychological interventions in British oncology services. This has been piecemeal (Fallowfield, 1988) and guided more by local factors than evidence of efficacy. There is little evidence based consensus about optimal methods of intervention, appropriate standards for clinical practice and training, or whether service provision is best directed towards prevention or the treatment of disorder (Fallowfield and Roberts, 1992;Hopwood and Maguire, 1992;Brennan and Sheard, 1994).The impact of psychological interventions in oncology on psychosocial, disease, symptom and treatment side-effect outcomes has been evaluated in a relatively large number of trials which vary considerably in their research questions, methodology, settings and results. Meyer and Mark (1995) aggregated all psychological outcomes for 45 such trials and reported a small mean effect size of 0.24 standard deviations for a single aggregate measure of psychological outcome. Their broad entry criteria ensured the inclusion of a large number of trials but the resulting extreme heterogeneity in terms of diversity of research questions and outcome measures render the meaning of this aggregate finding difficult to assess. We conducted, therefore, two metaanalyses of trials of interventions which sought to treat or prevent anxiety and/or depression. The relevance of the findings to clinical practice and service provision is assessed. METHODS Identical methods were used for the two meta-analyses Search strategyMedline, PsycLit and BIDS social sciences computerized databases were searched using the using the keywords cancer, counselling, psychotherapy, psychological therapy, group support/therapy, relaxation, imagery and visualization. Citations in identified papers and reviews (Watson, 1983;Cunningham, 1988;Vachon, 1988;Harman, 1991;Andersen, 1992;Trijsburg et al, 1992), Aslib. index to theses (keywords cancer, counselling and psychotherapy), and Comprehensive Dissertation Abstracts: Psychology (keyword cancer) were manually searched. SummaryThe findings of two meta-analyses of trials of psychological interventions in patients with cancer are presented: the first using anxiety and the second depression, as a main outcome measure. The majority of the trials were preventative, selecting subjects on the basis of a cancer diagnosis rather than on psychological criteria. For anxiety, 25 trials were identified and six were excluded because of missing data. The remaining 19 trials (including five unpublished) had a combined effect size of 0.42 standard deviations in favour of treatment against no-treatment controls (95% confidence interval (CI) 0.08-0.74, ...

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“…Several studies have also shown that cancer patients may benefit from psychological interventions (Watson, 1983;Andersen, 1992, Trijsburg et al, 1992. The use of cognitiveÐbehavioural techniques is well established for the treatment of both anxiety and depression in cancer patients (Greer et al, 1992;Fawzy et al, 1993;Watson et al, 1996).…”

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confidence: 99%

Predicting delayed anxiety and depression in patients with gastrointestinal cancer

Nordin

Glimelius

1999

Br J Cancer

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The aim of this study was to examine the possibility of predicting anxiety and depression 6 months after a cancer diagnosis on the basis of measures of anxiety, depression, coping and subjective distress associated with the diagnosis and to explore the possibility of identifying individual patients with high levels of delayed anxiety and depression associated with the diagnosis. A consecutive series of 159 patients with gastrointestinal cancer were interviewed in connection with the diagnosis, 3 months (non-cured patients only) and 6 months later. The interviews utilized structured questionnaires assessing anxiety and depression [Hospital Anxiety and Depression (HAD) scale], coping [Mental Adjustment to Cancer (MAC) scale] and subjective distress [Impact of Event (IES) scale]. Patient anxiety and depression close to the diagnosis were found to explain approximately 35% of the variance in anxiety and depression that was found 6 months later. The addition of coping and subjective distress measures did little to improve that prediction. A model using (standardized) cut-off scores of moderate to high anxiety, depression (HAD) and intrusive thoughts (IES subscale) close to the diagnosis to identify patients at risk for delayed anxiety and depression achieved a sensitivity of 75% and a specificity of 98%. Levels of anxiety and depression at diagnosis predicted a similar status 6 months later. The results also indicated that the HAD scale in combination with the IES intrusion subscale may be used as a tool for detecting patients at risk of delayed anxiety and depression. © 1999 Cancer Research Campaign

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Psychosocial intervention with cancer patients: a review

Cited by 98 publications

References 27 publications

Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer?

Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer?

The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses

Predicting delayed anxiety and depression in patients with gastrointestinal cancer

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