The effects of multidisciplinary psychosocial interventions on adult cancer patients: a systematic review and meta-analysis

Abstract

Purpose: To summarize evidence on the effects of multidisciplinary psychosocial rehabilitation interventions for adult cancer patients on fatigue, quality of life, participation, coping, and self-efficacy.Materials and methods: We searched MEDLINE, Embase, PyscINFO, PEDro, OT Seeker, Sociological Abstracts, CINAHL, and Cochrane CENTRAL for randomized controlled trials. Two reviewers selected articles independently.Results: Thirty-one articles were included and four meta-analyses were conducted. The results of one meta-analysis was statistically significant when comparing multidisciplinary psychosocial interventions to standard care on fatigue among breast cancer patients (standardized mean differences [SMD] 0.30 (95% confidence interval [CI] 0.04, 0.56)) at 2-6 months follow-up. However, no significant results were revealed on health-related quality of life among breast cancer (SMD 0.38 (95% CI -0.40, 1.16)), prostate cancer (SMD 0.06 (95% CI -0.18, 0.29)), and patients with different cancer diagnoses (SMD 0.06 (95% CI -0.14, 0.25)) at follow-up. One study reported on effects of interventions on participation, and four studied the outcomes of coping and self-efficacy.Conclusions: Multidisciplinary psychosocial interventions may decrease fatigue among breast cancer patients. There is an urgent need for rigorous designed trials in cancer rehabilitation, preferably on fatigue, participation, and coping or self-efficacy. The interventions need to be thoroughly described.Implications for rehabilitationMultidisciplinary psychosocial interventions may reduce fatigue among breast cancer patients.The effects of multidisciplinary psychosocial interventions among cancer patients on health-related quality of life, participation, and coping are unclear.Urgent need for a systemic approach to the development and conduction of multidisciplinary psychosocial interventions, ideally based on guidelines for complex interventions.Need of larger and more rigorously conducted randomized controlled trials investigating the effects of these rehabilitation interventions on fatigue, participation and coping.

Keywords: Cancer; fatigue; multidisciplinary interventions; quality of life; rehabilitation intervention; systematic review.