Reforming support systems of newly diagnosed brain cancer patients: a systematic review

Abstract

Purpose Despite the increasing incidence of currently incurable brain cancer, limited resources are placed in patients’ support systems, with reactive utilisation late in the disease course, when physical and psychological symptoms have peaked. Based on patient-derived data and emphasis on service improvement, this review investigated the structure and efficacy of the support methods of newly diagnosed brain cancer patients in healthcare systems. Methods This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Articles from PubMed, Embase, and CENTRAL databases were screened with six pre-established eligibility criteria, including assessment within 6 months from diagnosis of a primary malignant brain tumour. Risk of bias was evaluated using the Newcastle–Ottawa Scale and Critical Appraisal Skills Program (CASP) Qualitative Studies Checklist. Results Of 5057 original articles, 14 were eligible for qualitative synthesis. Four studies were cross-sectional and ten were descriptive. Information given to patients was evaluated in seven studies, communication with patients in nine, and patient participation in treatment decisions in eight. Risk of bias was low in ten studies, moderate in two, and high in two. Conclusions Techniques promoting individualised care increased perceived support, despite poor patient-physician communication and complexity of the healthcare system. Extracted data across 14 included studies informed a set of guidelines and a four-step framework. These can help evaluate and reform healthcare services to better accommodate the supportive needs of this patient group.

Brain cancer patients' levels of distress and supportive care needs over time

“…also highlighted the importance of communicating with carers to improve end of life care and reduce carer distress burnout and bereavement. Targeted communication skills training for clinicians focusing on communicating and assessing distress and unmet needs for people diagnosed with a brain tumour and their carers may assist clinicians in providing support and referring appropriately 38 . It is imperative cancer services, primary health care networks, and non‐government organisations such as Cancer Councils, work together to fill the gaps in care.…”

“…Targeted communication skills training for clinicians focusing on communicating and assessing distress and unmet needs for people diagnosed with a brain tumour and their carers may assist clinicians in providing support and referring appropriately. 38 It is imperative cancer services, primary health care networks, and non‐government organisations such as Cancer Councils, work together to fill the gaps in care. Further research is warranted to trial interventions to reduce patient and carer distress and address brain cancer specific unmet needs.…”

Scoping the psychological support practices of Australian health professionals working with people with primary brain tumor and their families

“…2,9 A recent systematic review found that care coordination and continuity, personalized information, and effective communication increased individuals' sense of support at diagnosis, irrespective of discipline. 30 Little is known, however, about the scope of practice of professionals involved in psychological support and whether this differs according to discipline and illness phase.…”

“…Multidisciplinary approaches to psychological support are strongly advocated, with recognition that medical, nursing, and allied health professionals can have differing yet complementary roles in provision of supportive care 2,9 . A recent systematic review found that care coordination and continuity, personalized information, and effective communication increased individuals' sense of support at diagnosis, irrespective of discipline 30 . Little is known, however, about the scope of practice of professionals involved in psychological support and whether this differs according to discipline and illness phase.…”

Critical Competences for the Management of Post-Operative Course in Patients with Digestive Tract Cancer: The Contribution of MADIT Methodology for a Nine-Month Longitudinal Study

“…In literature, many studies use quantitative methods to assess QoL in cancer patients [65][66][67][68][69]. Yet, at the same time, there is a lack of observations concerning the specific configuration of the patient's condition, including how the patient describes such a condition, how he/she gives a self-description and how he/she describes the other significant roles, and how the patient considers their own illness and symptoms.…”