A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer

Hoda Badr, Paul Krebs, Hoda Badr, Paul Krebs

Abstract

Objective: Quality of life (QOL) is a multidimensional construct that includes physical, psychological, and relationship well-being.

Methods: We conducted a systematic review and meta-analysis of randomized controlled studies published between 1980 and 2012 of interventions conducted with both cancer patients and their partners that were aimed at improving QOL. Using bibliographic software and manual review, two independent raters reviewed 752 articles with a systematic process for reconciling disagreement, yielding 23 articles for systematic review and 20 for meta-analysis.

Results: Most studies were conducted in breast and prostate cancer populations. Study participants (N = 2645) were primarily middle aged (mean = 55 years old) and white (84%). For patients, the weighted average effect size (g) across studies was 0.25 (95% CI = 0.12-0.32) for psychological outcomes (17 studies), 0.31 (95% CI = 0.11-0.50) for physical outcomes (12 studies), and 0.28 (95% CI = 0.14-0.43) for relationship outcomes (10 studies). For partners, the weighted average effect size was 0.21 (95% CI = 0.08-0.34) for psychological outcomes (12 studies) and 0.24 (95% CI = 0.6-0.43) for relationship outcomes (7 studies).

Conclusion: Therefore, couple-based interventions had small but beneficial effects in terms of improving multiple aspects of QOL for both patients and their partners. Questions remain regarding when such interventions should be delivered and for how long. Identifying theoretically based mediators and key features that distinguish couple-based from patient-only interventions may help strengthen their effects on patient and partner QOL.

Keywords: behavior; cancer; couples; distress; interventions; meta-analysis; quality of life; randomized-control trial; relationship satisfaction; systematic review.

Copyright © 2012 John Wiley & Sons, Ltd.

Figures

Figure 1. Flow Diagram Depicting the Systematic…
Figure 1. Flow Diagram Depicting the Systematic Review Process
Figure 2. Forest Plots of Patient and…
Figure 2. Forest Plots of Patient and Partner Effect Sizes and 95% Confidence Intervals
Figure 3. Funnel Plots of Patient and…
Figure 3. Funnel Plots of Patient and Partner Outcomes

Source: PubMed

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