Seeking to determine whether psychosocial interventions lead to improvements in cancer-related pain, the authors of a recent meta-analysis examined data from 37 randomized controlled studies published between 1983 and 2010. The studies involved a total of 4,199 patients. At baseline 54% of patients were receiving chemotherapy, and 65% of the studies involved cancers at mixed stages.

The most common types of psychosocial interventions were skills training and education, both of which were provided in approximately half of the studies. Skills training included cognitive behavioral therapy, relaxation, hypnosis, and experiential interventions. Most interventions were provided to individuals (90% of studies) rather than in a group setting, and nurses often provided the intervention (63% of studies). The control groups consisted most often of patients receiving usual care (64% of studies).

The weighted average effect size for pain severity across studies was 0.34, indicating that psychosocial interventions moderately affected severity. The authors also examined the impact of interventions on the effect of pain on factors related to daily living, such as sleep, patients' ability to work, and social interactions. In this regard, psychosocial interventions also moderately lessened interference with daily life, with a weighted average effect size of 0.40. Skills-based interventions and education produced similar results; skills-based interventions providing a slightly higher effect size, but not significantly so. Patients in the intervention groups received an average of six interventions; however, effect wasn't associated with the number of sessions patients received.

Based on their analysis, the authors conclude that psychosocial interventions help reduce cancer-related pain and its effects on daily living and that these interventions should be incorporated into pain-management plans for patients with cancer.-SDSJ

Reference