A systematic review of cognitive behavioral interventions in advanced cancer

Objective: To systematically review cognitive behavioral interventions for people with advanced cancer. Methods: A literature search was conducted using Medline(C), CINAHL(C), and Psych-info(C). Inclusion criteria: studies were included in the review if they met the following criteria: (1) the design was a randomized clinical trial, (2) the study tested a cognitive behavioral therapy, including psycho-educational, alternative and complementary therapies (i.e. acupuncture, relaxation), expressive, support and skill building interventions, (3) participants were adults (18 years of age or older) with advanced cancer and the (4) outcomes were directly related to the patient with advanced cancer. Results: 11 studies met the inclusion criteria. Of the studies in the review: treatment effects were not statistically significant in most studies, methods were not consistently described, and samples had limited racial/ethnic diversity. Conclusion: The interpretation of the effectiveness of the CBIs was limited by major challenges to the internal validity of the studies included in the review. The lack of data about the efficacy of CBIs to support people with advanced cancer is a gap in the current knowledge base. Practice implications: Given the needs of people living with advanced cancer well-designed studies are needed to test interventions that will improve outcomes for people living with advanced cancer. (C) 2012 Elsevier Ireland Ltd. All rights reserved.