The Psychosocial Components of Multimodal Interventions Offered to People with Cancer Cachexia: A Scoping Review

Abstract

The supportive care of people with cancer cachexia is a rapidly evolving field. In the past decade, multimodal treatments have been developed and new multidisciplinary cachexia clinics have been established across the world. This scoping review examines the extent to which psychosocial support has become part of the multimodal management of cancer cachexia. The review draws on a systematic search of Medline, Embase, CINAHL, PsycINFO, and the Cochrane Library for publications about people who have cancer cachexia and receive multimodal interventions. Search limits were the English language, date range January 2013 to March 2021, and adults 18 years and older. The search found 19 papers about multimodal interventions for either cancer cachexia or its defining feature involuntary weight loss that included a psychosocial component. This review found three different ways a psychosocial component of a multimodal intervention can help patients: (1) enable adherence to multimodal therapies; (2) aid emotional adaptation and coping; and (3) treat comorbid anxiety and depression. Recognizing these three different functions of psychosocial support is important because they have different mechanisms of action. Behavioral change techniques are important for enabling adherence, education in coping methods is important to alleviate stress, and cognitive reframing for the treatment of anxiety and depression. The analysis reveals that multimodal interventions for cancer cachexia with a psychosocial component can either focus on physical health or have a more holistic focus. Holistic care is considered the best practice in cancer nursing. Thus multimodal interventions that can address not only physical health problems, but psychosocial issues are consistent with high-quality nursing care.

Psychological symptoms of illness and emotional distress in advanced cancer cachexia

“…In three cases, family members were monitor and feedback to enhance patient engagement with the intervention. This is important because of the relationship between patient and family member eating-related distress and the relationship between family and QoL in cachexia [7,15,16]. Best practice in cachexia management uses multimodal interventions to its multiple associated problems [8,9].…”

Development and validation of questionnaires for eating‐related distress among advanced cancer patients and families

“…Cancer cachexia is a syndrome with physical and psychological symptoms in patients with cancer, including a lack of appetite, early satiety, reduced dietary intake, fatigue, drowsiness and depression. These symptoms are worsened by cancer treatments and can lead to psychosocial distress in patients 3–5 . These burdens also greatly impact on their family caregivers and relationships between patients and family caregivers 3–5 .…”

“… 3 , 4 , 5 These burdens also greatly impact on their family caregivers and relationships between patients and family caregivers. 3 , 4 , 5 Eating‐related distress (ERD) is one type of psychosocial distress in patients and family caregivers, and its alleviation is a key issue in palliative care. 3 , 4 , 5 However, few studies have investigated the prevalence and severity of ERD among patients and family caregivers.…”

“… 3 , 4 , 5 Eating‐related distress (ERD) is one type of psychosocial distress in patients and family caregivers, and its alleviation is a key issue in palliative care. 3 , 4 , 5 However, few studies have investigated the prevalence and severity of ERD among patients and family caregivers. 3 , 4 , 5 In our previous study, three factors were extracted in ERD experienced by patients as follows: (i) lack of appetite and reduced dietary intake, (ii) insufficient information about the patient's diet and eating problems and (iii) conflicts over food between patients and their family caregivers.…”

A Randomized Controlled Trial Study of a Multimodal Intervention vs. Cognitive Training to Foster Cognitive and Affective Health in Older Adults

“…However, studies that combined different of these intervention factors produced promising results regarding transfer effects on non-trained factors, such as cognitive and executive functions, activities of daily living, and emotional coping ( cf. for recent reviews Chalfont et al, 2020 ; Grueso and Viejo-Sobera, 2021 ; Hopkinson, 2021 ; Rundek et al, 2021 ; Omura and Araki, 2022 ). Other interventions with older people that combined CT with physical exercise or with diet showed effects on well-being and cognitive abilities in everyday life ( Oswald et al, 2006 ; Ngandu et al, 2015 ; Maffei et al, 2017 ; Takeuchi et al, 2020 ).…”