Who benefits from psychosocial interventions in oncology? A systematic review of psychological moderators of treatment outcome

Abstract

Medical and demographic characteristics and psychological morbidity of individuals with cancer prior to a psychosocial intervention can influence the efficacy of interventions. However, little is known about the moderating role of patients' psychosocial characteristics on intervention effects. This review sought to identify and synthesize the impacts of psychosocial moderators of the effect of psychosocial interventions on the psychological well-being of cancer patients. A systematic review of the published literature was conducted. Databases searched included PsycINFO, PubMed, MEDLINE, Scopus, CINAHL, Web of Science, and Psychology and Behavioural Sciences Collection. Randomized controlled studies examining a moderator effect of patients' psychosocial characteristics other than baseline depression and anxiety levels were included. Of 199 potential papers, a total of 20 studies, involving 3,340 heterogeneous cancer patients are included. Of the 17 potential psychosocial moderators examined in this review, 14 significantly moderated the effects of interventions. Moderators were categorized into personality traits, mental and physical quality of life, social environment, and self-efficacy. Patients with poorer quality of life, interpersonal relationships and sense of control benefitted more from interventions than those who already had adequate resources. Patients with low levels of optimism and neuroticism, high levels of emotional expressiveness, interpersonal sensitivity, and dispositional hypnotizability also showed greater benefits from various interventions. This review adds to the growing literature aimed at personalizing psychosocial cancer treatment by identifying who benefits from which psychosocial interventions.

Improvement in Stress, General Self-Efficacy, and Health Related Quality of Life following Patient Education for Patients with Neuroendocrine Tumors: A Pilot Study

“…Systematic reviews of intervention studies in which patients acquired new skills and gained confidence to manage their disease show various effects with regard to outcomes such as stress, self-efficacy, and HRQoL [13, 15, 16, 28]. For instance, findings from a literature review of randomized controlled trials (RCT) by McGregor and Antoni demonstrate reduced levels of stress following cognitive behavioral interventions in women treated for breast cancer [11], similar to results from the present study.…”

“…Tamagawa et al [28] summarized the benefits from psychosocial interventions in oncology: the types of interventions were as follows: cognitive-behavioral stress management cognitive behavioral therapy; expressive writing, support group alone; psychoeducation, support group plus psychoeducation; psychoeducation and life style and coping training; individual supportive counseling; a booklet including self-management skills and stories of other patients' experiences; and a booklet for treatment decision making. The results indicated that those with low levels of self-efficacy initially benefited from psychosocial interventions, while those with higher levels of self-efficacy at baseline did not [28]. Similar to our findings, educational interventions have led to improvements in HRQoL in other cancer populations.…”

“…Core components of chronic care interventions could also be based on the principles of self-efficacy to help motivate patients to self-manage their symptoms and adopt new skills and competencies. Different components of patient education such as patient and family knowledge, provision of emotional and psychosocial support, self-efficacy, coping skills, and relaxation training have been shown to be effective in reducing stress and improving HRQoL across settings and disease conditions [13, 15, 16, 24–28]. …”

Depressive Spectrum Disorders in Cancer: Diagnostic Issues and Intervention. A Critical Review

“…The types of psychotherapy approaches in cancer patients with depression are vast (from cognitive-behavior therapy to existential-based intervention, from psychodynamically oriented therapy to educational, relaxation, expressive-supportive therapy, and other forms of treatment, such as mindfulness), supporting the view that it is more important to focus on participants’ variables (e.g., level of depressive symptoms, type and stage of cancer, personality variables) [68] rather than the type of intervention itself [69, 70]. For example, a systematic review [71] examining 199 potential papers, of which a total of 20 studies were selected and involved 3,340 heterogeneous cancer patients, showed that cancer patients who had the greater benefit from intervention were those who reported low levels of optimism and neuroticism; high levels of emotional expressiveness, interpersonal sensitivity, and dispositional hypnotisability; and poorer quality of life, interpersonal relationships, and sense of control.…”

Working mechanisms of a web-based self-management intervention for cancer survivors: a randomised controlled trial

“…beliefs about personal abilities to control the illness). Higher personal control has been shown to be related to patients' psychosocial and physical well-being (Ashley, Marti, Jones, Velikova, & Wright, 2015;Hagger & Orbell, 2003;Tamagawa, Garland, Vaska, & Carlson, 2012). Personal control is one of the components of illness perceptions in Leventhal's Common Sense Model (Leventhal, Nerenz, & Steele, 1984).…”