Psycho-oncologic interventions to reduce distress in cancer patients: A meta-analysis of controlled clinical studies published in People’s Republic of China

Abstract

OBJECTIVE: This study aimed to summarize the current result of controlled clinical studies published in China and analyzed the effect of psycho-oncologic interventions on distress of cancer patients. METHODS: Electronic searches were conducted in four databases. The study inclusion criteria were established on the basis of the PICOS (population, intervention, comparator, outcomes, and study design) framework. The main outcome measures were emotional distress, anxiety, and depression. Meta-analytic techniques were applied to analyze published data from the retrieved studies. RESULTS: A total of 207 controlled studies (involving 19,607 cancer patients) were included, among which 31 studies (3007 patients) were meta-analyzed. Pooled analysis showed large effects for psycho-oncologic interventions on anxiety (d = -8.71, p < 0.001) and depression (d = -8.12, p < 0.001). Health education combined with psychological support (d = -8.17, p = 0.04) or with relaxation training (d = -12.95, p < 0.001) significantly lowered the anxiety level in cancer patients. However, health education combined with relaxation training did not lower the depression levels (p > 0.05). Nurses were the primary health professionals (69.08%) responsible for delivering interventions. Meanwhile, none of the reports followed all the items of the consolidated standards of reporting trials checklist. Most studies suffered from some flaws concerning blinding, randomization procedures, participant follow-up, attrition, and so on. CONCLUSION: The findings pointed out that psycho-oncologic interventions significantly reduced distress in cancer patients of China; however, the quality of the randomized controlled trials was low. In the future, reports on controlled clinical studies should follow the consolidated standards of reporting trials statement and supply more comprehensive information.