Effectiveness of psychosocial interventions on health outcomes of children with cancer: A systematic review of randomised controlled trials.

INTRODUCTION: Nowadays, there is promising evidence that psychosocial interventions could be helpful in paediatric oncology. Thus, this review aimed to describe the impact of psychosocial interventions on cancer-related health outcomes in children. METHODS: Fifteen English electronic databases were searched from October to December 2020. Only randomised controlled trials that (1) included children ≤18 years old diagnosed with cancer, (2) evaluated the effects of psychosocial interventions, and (3) reported health outcomes including quality of life, anxiety, depression, stress, distress, self-esteem, psychological adjustment, treatment adherence, pain, fatigue, and academic performance were included. RESULTS: Ten RCTs were included in this review. Six types of psychosocial interventions (social skill training, music-based intervention, therapeutic play, cognitive therapy, wish intervention, and art therapy) were identified. The studies were assessed as having low to high risk of bias. Nine of the studies reported significant improvement in at least one outcome measure. But quantifying the pooled effect was not applicable due to the heterogeneity of interventions. CONCLUSION: Psychosocial interventions could be beneficial in paediatric oncology. Yet, the outcomes were reported in heterogeneous types of interventions and participants. The results underscore the need to conduct further studies that include participants with specific cancer diagnoses and types of interventions.

Effects of cognitive-behavioural therapy on psychological, physical and social outcomes of children with cancer: A systematic review and meta-analysis.

OBJECTIVE: This systematic review aimed to summarise the effects of cognitive-behavioural therapy on psychological, physical and social outcomes of children with cancer without limitations on publication date. METHODS: Thirteen English and seven Chinese electronic databases were searched from April to June 2021. Randomised control trials, quasi-experimental studies, pre-test post-test studies with a control group, factorial or cross-over designs that included children ≤18 years old and during various stages of the cancer trajectory, who have received cognitive-behavioural therapy, and reported (anxiety, depression, stress, quality of life, self-efficacy, fatigue, pain, behavioural distress, anger, and/or academic performance) were included. RESULTS: Eight studies with quality of evidence ranging from low to high risk of bias were included. The results show cognitive-behavioural therapy has favourable effects on anxiety, depression, pain and behavioural distress. The meta-analysis also show that it reduces anxiety (SMD = -0.89, 95% CI (-1.45, -0.32), p < 0.002), depression (SMD = -0.90, 95% CI (-1.40, -0.39), p < 0.0005), and pain (SMD = -0.56, 95% CI (-1.04, -0.08), p < 0.002). It also has a favourable effect on stress, anger and self-efficacy, though the results are drawn from a single study. CONCLUSION: Cognitive-behavioural therapy has the potential to reduce anxiety, depression and pain for children with cancer. It also shows promise in reducing behavioural distress. Although effects on stress, anger, and self-efficacy have been found to be significant, there have been limited studies on these aspects of functioning and more research is needed. The findings are drawn from heterogeneous participants and interventions, thus emphasising the need to conduct well-designed intervention studies, including cancer survivors.