J Korean Acad Nurs.  2013 Oct;43(5):658-668. 10.4040/jkan.2013.43.5.658.

Meta-analysis of Psychosocial Interventions to Reduce Pain in Patients with Cancer

• Oh PJ
• Han SJ

• KMID: 1707167
• DOI: http://doi.org/10.4040/jkan.2013.43.5.658

Abstract

PURPOSE
The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients.
METHODS
Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library.
RESULTS
Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected.
CONCLUSION
This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

Keyword

Neoplasm; Pain; Intervention studies; Meta-analysis

MeSH Terms

Clinical Trials as Topic
Cognitive Therapy
Databases, Factual
Humans
Neoplasms/*complications/*psychology
Pain/*etiology
*Pain Management
Questionnaires

Figure

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  Figure 1. Flow of studies included from database search.

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  Figure 2. Forest plot of effect size and 95% CI by cognitive behavioral therapy on pain & funnel plot of effective sizes by standard error for pain.

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  Figure 3. Forest plot of effect size and 95% CI by education interventions on pain & funnel plot of effective sizes by standard error for pain.

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  Figure 4. Forest plot of effect size and 95% CI by psychosocial intervention on pain & funnel plot of effective sizes by standard error for pain.

Reference

References

Cohen J. 1998. Statistical power analysis for the behavioral science. 2nd ed.Hillsdale, NJ: Lawrence Erlbaum Associates.

Devine E C. 2003. Meta-analysis of the effect of psychoeducational interventions on pain in adults with cancer. Oncology Nursing Forum. 30(1):75–89. http://dx.doi.org/10.1188/03.onf.75-89.

Egger M., Smith G D., Schneider M &., Minder C. 1997. Bias in meta-analysis detected by a simple, graphical test. BMJ: British Medical Journal. 315(7109):629–634.

Fawzy F I., Fawzy N W., Arndt L A &., Pasnau R O. 1995. Critical review of psychosocial interventions in cancer care. Archives of General Psychiatry. 52(2):100–113.

Galway K., Black A., Cantwell M., Cardwell C R., Mills M &., Donnelly M. 2012. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. The Cochrane Database of Systematic Reviews. 11:CD007064. http://dx.doi.org/10.1002/1465 1858.CD007064.pub2.

Golden R N. 2004. Making advances where it matters: Improving outcomes in mood and anxiety disorders. CNS Spectrums. 9(6 Suppl 4):14–22.

Gorin S S., Krebs P., Badr H., Janke E A., Jim H S., Spring B. . 2012. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. Journal of Clinical Oncology. 30(5):539–547. http://dx.doi.org/10.1200/jco.2011.37.0437.

Higgins J P., Thompson S G., Deeks J J &., Altman D G. 2003. Measuring inconsistency in meta-analyses. BMJ: British Medical Journal. 327(7414):557–560. http://dx.doi.org/10.1136/bmj.327.7414.557.

Hodges L J., Walker J., Kleiboer A M., Ramirez A J., Richardson A., Ve-likova G. . 2011. What is a psychological intervention? A metareview and practical proposal. Psycho-Oncology. 20(5):p. 470–478. http://dx.doi.org/10.1002/pon.1780.

Jang S Y &., Park J S. 2011. The meta-analysis of the effect of acupressure for nausea and vomiting in cancer patients receiving chemotherapy. Journal of Korean Oncology Nursing. 11(2):116–126. http://dx.doi.org/10.5388/jkon.2011.11.2.116.

Jassim G A., Whitford D L &., Grey I M. 2010. Psychological interventions for women with non-metastatic breast cancer (Protocol). The Cochrane Database of Systematic Reviews. 10:CD008729. http://dx.doi.org/10.1002/14651858.CD008729.

Kim J N &., I R. 2008. A review of research on the psychosocial interventions for the cancer patients. The Korean Journal of Psychology. 13(2):329–357.

Kim M Y &., Oh P J. 2011. Meta-analysis of the effectiveness on foot-re-flexo-massage for cancer patients. Journal of Korean Oncology Nursing. 11(2):127–135. http://dx.doi.org/10.5388/jkon.2011.11.2.127.

Kim S Y., Park J E., Seo H J., Seo H S., Song H J., Shin C M. . 2011. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency.

Kim Y H., Kwon I K., Kim J H., Seol M E., Jun M H., Ham Y H. . 2011. ). Cancer symptom management. Seoul: Hyunmoonsa.

Korean Society Pharmacoepidemiology and Risk Management. 2011. Pharmacoepidemiology. Seoul: Seoul National University Press.

Kwon I G. 2004, June 1. Psychosocial care for pain in cancer patients. Paper presented at the Korean oncology nursing society continuing education. Spring 2004. Seoul:

Min Y C &., Oh P J. 2011. A meta-analysis of intervention studies on cancer pain. Journal of Korean Oncology Nursing. 11(1):83–92. http://dx.doi.org/10.5388/jkon.2011.11.1.83.

Montgomery G H &., Bovbjerg D H. 2004. Presurgery distress and specific response expectancies predict postsurgery outcomes in surgery patients confronting breast cancer. Health Psychology. 23(4):381–387. http://dx.doi.org/10.1037/0278-6133.23.4.381.

National Cancer Information Center. 2013. Survival rate: Five-year cancer relative survival rates. Retrieved January 30 2013, from. http://www.cancer.go.kr/mbs/cancer/subview.jsp?id=cancer_040302000000.

Oh P J &., Choi H J. 2012. The effect of patient education interventions on distress, self-care knowledge and self-care behavior of oncology patients: A meta-analysis. Asian Oncology Nursing. 12(4):257–266. http://dx.doi.org/10.5388/aon.2012.12.4.257.

Oh P J &., Kim Y H. 2012. Meta-analysis of spiritual intervention studies on biological, psychological, and spiritual outcomes. Journal of Korean Academy of Nursing. 42(6):833–842. http://dx.doi.org/10.4040/jkan.2012.42.6.833.

Oh S S. 2009. Meta-analysis: Theory and practice. Seoul: Konkuk University Press.

Osborn R L., Demoncada A C &., Feuerstein M. 2006. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: Meta-analyses. International Journal of Psychiatry in Medicine. 36(1):13–34.

Raingruber B. 2011. The effectiveness of psychosocial interventions with cancer patients: An integrative review of the literature (2006-2011). ISRN Nursing, 2011. 638218:http://dx.doi.org/10.5402/2011/638218.

Ranchor A V., Fleer J., Sanderman R., van der Ploeg K M., Coyne J C &., Schroevers M. 2012. Psychological interventions for cancer survivors and cancer patients in the palliative phase (Protocol). The Cochrane Database of Systematic Reviews. 1:CD009511. http://dx.doi.org/10.1002/14651858.CD009511.

Rehse B &., Pukrop R. 2003. Effects of psychosocial interventions on quality of life in adult cancer patients: Meta analysis of 37 published controlled outcome studies. Patient Education and Counseling. 50(2):179–186.

Schwarzer G. 2013. Meta: Meta-analysis with R. Version 3.0-1. Retrieved March 20 2013, from. http://cran.r-project.org/web/packages/meta/index.html.

Sutton A J., Duval S J., Tweedie R L., Abrams K R &., Jones D R. 2000. Empirical assessment of effect of publication bias on meta-analyses. BMJ: British Medical Journal. 320(7249):1574–1577.

Tatrow K &., Montgomery G H. 2006. Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: A meta-analysis. Journal of Behavioral Medicine. 29(1):17–27. http://dx.doi.org/10.1007/s10865-005-9036-1.