Psychooncology
Psychooncology
Psychooncology
Abstract
Oncologic disease is now more prevalent overall thanks to advancements in medicine, better
living circumstances overall, and longer life expectancies. More importantly, a growing
number of patients are surviving cancer or dealing with it for an extended length of time.
While the fight for survival is ongoing, enhancing the quality of life for patients has taken
centre stage. While psychosocial factors may alter the course of the illness, they primarily
have a significant effect on patients' physical and mental health. A relatively new
interdisciplinary discipline called psycho-oncology has emerged with the goal of addressing
these problems and offering assistance to patients who are dealing with a variety of
difficulties throughout the various stages of their illness.
Method
Study identification
Studies included in the larger review (Moyer et al., in press) examined psychosocial
interventions for adult cancer patients that (1) reported outcomes on psychological,
emotional, behavioral, physiological, functional, or medical status; (2) were first reported as a
published article or dissertation between January 1980 and December 2005; and (3) included
10 or more individuals per group. Electronic databases (PsycINFO, which indexes
dissertations; PubMed; and Dissertation Abstracts Online, which indexes doctoral theses
from 1861 to the present from US, Canadian, British, and European universities [10] were
searched using key terms (e.g. cancer, neoplasms, tumor, and psychosocial intervention,
psychotherapy, psychological treatment, education, cognitive behavioral, relaxation, stress
management, support group, selfhelp group, nursing intervention, biofeedback). The
reference lists of included reports and of 94 prior reviews and meta-analyses were also
examined. Searches for articles citing prior reviews and the tables of contents of several
journals (PsychoOncology, Journal of Clinical Oncology, Cancer, Journal of Psychosocial
Oncology, European Journal of Cancer, and Cancer Nursing) were conducted. Separate
reports based on the same sample (e.g. separate articles reporting outcomes at 3-month and
12-month follow-ups) were consolidated as being from the same project. The larger sample
included 673 reports comprising 488 projects, 107 of which included dissertations. As some
projects yielded multiple dissertations tions reported on more than one project), there were
112 dissertations conducted across the 107 projects. However, our analyses were at the
project level. A follow-up search of the PubMed and PsycINFO bibliographic databases
determined if unpublished dissertations had been published by November 2008. For projects
that yielded more than one dissertation, if at least one was published, we coded the project as
published. In all, 42 projects comprised (at least one) dissertation that had been published and
65 projects comprised (at least one) dissertation that had not been published; for simplicity,
we refer to these as published dissertations and unpublished dissertations, respectively.
Study coding
Coding of descriptive project characteristics involved the types of interventions that had been
investigated and whether the project had received research funding. Because some authors
have noted difficulties in tracking dissertations when female investigators have married and
changed their names [6], we also examined whether our coding of publication status was
linked to the gender of the principal investigator. Coding items assessing the quality of study
methodology and reporting were adapted from prior work [11]. Although consensus on
essential areas of methodological quality has yet to be reached, and no one scale is considered
appropriate for all research topic areas [12] we included aspects of quality conventionally
considered important. These involved aspects of the sample description; the research design,
including the quality of randomization, where applicable; intervention specification and
provision; and data analyses, such as whether intent-to-treat analyses were conducted. Owing
to the low feasibility of keeping participants and interventionists blind to treatment groups for
psychosocial interventions, items assessing this were not included. Similarly, because
outcomes in this area are predominantly based on self-report, assessments of blinding of
outcome assessors were also not included. Aspects of reporting from the CONSORT [13],
such as noting the number dropping out of treatment, were also evaluated. Combining
elements related to different dimensions of methodological quality is not advised because
they are theoretically independent and may be negatively related [2]. Therefore, we report
these elements of methodological quality separately. Because prior research has shown that
studies in the published literature have more participants than studies in the gray literature
[5], we also examined sample size. Finally, to address the question of publication bias, we
coded whether or not a project reported at least one significant intervention effect.
Results
Statistical analyses
For continuous outcome variables, we used t-tests to compare published and unpublished
dissertations. For categorical outcome variables, we used w2 tests and Fisher’s exact test
when cells had an expected count of less than 5. A Bonferronicorrected a level of 0.002
(0.05/26) was adopted to account for the multiple tests of significance conducted. Results
Investigator, report, and intervention characteristics Published dissertations were significantly
more likely to have had some form of research funding (73.7%) than unpublished
dissertations (26.3%, w2 [1, N 5 107] 5 29.30, p 5 0.000). The proportion of female principal
investigators was somewhat greater (85.7%) for published dissertations than for unpublished
dissertations (67.2%, w2 [1, N 5 106] 5 4.59, p 5 0.032), but this difference was not
significant at the corrected a level. There were no significant differences in the likelihood of
published versus unpublished dissertations’ examining cognitive, behavioral, or cognitive–
behavioral.
Discussion
References
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