professional interventions besides support of the self management strategies and patient system ... 140 stage 3 or 4 lun
Non-pharmacological Interventions to Decrease Anxiety in Advanced Cancer Patients: A Systematic Review D. Zweers RN, MSc; E. de Graaf RN, MSc; Prof. S. Teunissen RN PhD Background Anxiety is a common symptom in palliative care (49-51%) and increases as patients become aware of the ineffectiveness of medical treatments, progression of their illness and their limited life expectancy. Anxiety could affect patients’ decisionmaking and quality of life and requires professional interventions besides support of the self management strategies and patient system. Due to different causes of anxiety and the difficulty to distinguish between psychological and somatic symptoms, the management of anxiety in daily practice is a challenging problem. In this systematic literature review we focus on anxiety ‘as a symptom’ caused by the illness and/or consequences of treatment.
Purpose To provide insight into the effectiveness of nonpharmacological interventions on the management of anxiety in advanced cancer patients. Method: a systematic literature review Pubmed, Embase, Cinahl, PsychINFO and Cochrane were searched. Randomized clinical trials, written in English, evaluated nonpharmacological interventions in advanced cancer patients were included. Data collection and analyses Two authors independently assessed all the retrieved studies. A quality appraisal was conducted using the risk of bias tool (figure 1).
Results Sixteen studies (table 1) were included and categorized into three groups: 1. Telemonitoring interventions and education 2. Psychotherapeutic interventions 3. Complementary care interventions Nine of the 16 interventions were performed by nurses, 5 interventions by psychologists/ therapists and for 2 interventions it was not clear which profession was involved. Only 4 studies in group 1 and 2 showed significant improvement of the experienced anxiety compared with the control group. Commonly success factors in these four effective interventions are shown in figure 2.
Table 1: Overview of included studies First author (year) 1. Breibart (2010) 2. Breibart (2012) 3. Bruera (2008) 4. Chan (2011)
Intervention
Control
N
Outcome
Meaning-centered group psychotherapy Individual Meaning centered psychotherapy Expressive writing
Supportive psychotherapy
-
Psycho educational intervention
Briefing RT procedure+ optional group talk
98 advanced cancer patients 120 advanced cancer patients 24 advanced cancer patients 140 stage 3 or 4 lung cancer patients 174 advanced cancer patients 40 advanced cancer patients
-
108 advanced cancer patients 24 advanced ovarian cancer patients 189 advanced breast colon or prostate cancer
-
207 advanced colorectal cancer patients
-
Medical treatment, adequate symptom management and psychological support Usual care
