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 rehabilitation

• Multidisciplinary 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
• rehabilitation intervention
• multidisciplinary interventions
• quality of life
• fatigue
• systematic review

Acknowledgements

The authors would like to thank Erna Hogrenning (patient representative), Åse Sagen (physiotherapist, researcher), Randi Gjessing (specialist nurse in sexology), Savar Gudbergsson (social worker, PhD, researcher), and Roy Nystad (MD, neurologist) for deciding the research question and the inclusion criteria for this systematic review. Thanks also to Ingvild Kirkehei (research librarian) for conducting the literature search, to Jenni Moore (senior researchers) for valuable comments on the manuscript and to Geir Smedslund (senior researcher) for methodological contributions.

Disclosure statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

Financial support for this systematic review was provided by Regional Knowledge Translation Center, Sunnaas Rehabilitation Hospital, Norway.