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. 2016 May-Aug;16(2):211-219.
doi: 10.1016/j.ijchp.2015.07.005. Epub 2015 Aug 29.

Psychological treatments to improve quality of life in cancer contexts: A meta-analysis

Alejandro de la Torre-Luque  1 , Hilda Gambara  2 , Escarlata López  3 , Juan Antonio Cruzado  4
Affiliations

Psychological treatments to improve quality of life in cancer contexts: A meta-analysis

Alejandro de la Torre-Luque et al. Int J Clin Health Psychol. 2016 May-Aug.

Abstract
in English, Spanish

This study aimed to analyze the effects of psychological treatments on quality of life among cancer patients and survivors. Additionally, it was explored the moderating influence of some medical- and treatment-related features on these effects. Scientific studies published between 1970 and 2012 were analyzed. Seventy-eight studies were included in a meta-analysis. Concerns related to samples, interventions, and standard of methodological evidence were explored across the studies. A significant overall effect size of psychological interventions was revealed (g = .35). Clinical state and use of adjuvant psychological treatment for managing medical side effects moderated this result (p < .05). Furthermore, a meta-regression model was showed significant (R 2 = .30) so as to explain the quality of life change associated with psychological interventions. The psychotherapeutic benefits on depressive symptomatology were included as a moderating factor. To sum up, quality of life is improved by psychological interventions, especially when patients have to cope with medical treatment or with adjustment after the disease is treated. Psychological treatments tend to promote better outcomes when depressive symptomatology is managed. These findings support that providing psychological treatments should be considered as crucial for the patient's health in cancer contexts.

Este estudio pretende conocer el efecto de los tratamientos psicológicos sobre la calidad de vida de pacientes y supervivientes de cáncer, así como la influencia moderadora de variables médicas y propias del tratamiento sobre dicho efecto. Para ello, se realizó un meta-análisis que incluyó 78 trabajos publicados entre 1970 y 2012. Se analizaron aspectos relacionados con la muestra, el tratamiento y la calidad metodológica de estos estudios. Como resultado, se encontró un tamaño del efecto significativo de los tratamientos psicológicos sobre la calidad de vida (g = 0,35). Dicho efecto estaba moderado por el estado clínico del paciente y la adyuvancia del tratamiento psicológico con el médico (p < 0,05). También se observó que mayores reducciones de sintomatología depresiva debidas al tratamiento llevaban a mayores beneficios sobre la calidad de vida según las meta-regresiones ejecutadas (R 2 = 0,30). En conclusión, los tratamientos psicológicos pueden mejorar la calidad de vida de pacientes oncológicos, principalmente cuando deben afrontar tratamientos médicos, así como de los supervivientes. Además, cuando se reduce la sintomatología depresiva la calidad de vida suele mejorar. Estos resultados destacan la influencia decisiva de los tratamientos psicológicos para la salud integral en contextos oncológicos.

Keywords: Cancer; Depression; Meta-analysis; Psychological interventions; Quality of life.

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Figures

Figure 1
Figure 1
Flow diagram of study selection. Note. Screening review was based on title article, abstract, and key words.
Figure 2
Figure 2
Overall effect sizes in relation to significant categorical models. Note. This figure includes overall effect sizes in function of two categorical factors. The Graph A depicts overall effect sizes regarding patient's clinical stage. Likewise, overall effect sizes in function of whether the psychological intervention is applied for reducing the effects of ongoing medical oncologic treatments (adjuvant treatment) or not, are presented in the Graph B. Overall effect sizes for all categories with confidence interval (between square brackets) are included. ES = Effect size.
Figure 3
Figure 3
Contour-enhanced funnel plot for publication bias detection. Note. Statistical nonsignificance for asymmetry is displayed at 99% (white area), 95% (grey area) and 90% (dark grey area) confidence interval.
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