Systematic Review and Meta-analysis of Psychosocial Uncertainty Management Interventions.

BACKGROUND: Psychosocial uncertainty management interventions (UMIs) targeting patients and their family members might help to alleviate the negative influences of illness-related uncertainty, such as diminished quality of life and poor adjustment. OBJECTIVES: The aims of this study were to evaluate the key characteristics of psychosocial UMIs and assess intervention effects on patients' and their family members' short-term and long-term illness-related uncertainty. METHODS: We conducted a systematic review and meta-analysis of psychosocial UMIs published through 2017. We performed a comprehensive electronic search and manual review. The outcome indicator was illness-related uncertainty experienced by patients or their family members. RESULTS: We included 29 studies in the systematic review and 14 studies in the meta-analysis. The main intervention components were information and resource provision, coping skills training, social and emotional support, communication skills, symptom management and self-care, coordination of care, and exercise. Compared to usual care, patients who received UMIs reported less uncertainty immediately after intervention delivery (g = -0.44, 95% confidence interval [CI] [-0.71, -0.16]) and at later follow-up points (g = -0.47, 95% CI [-0.91, -0.03]). Family members who received UMIs also reported less uncertainty immediately after intervention delivery (g = -0.20, 95% CI [-0.33, -0.06]) and at later follow-up points (g = -0.20, 95% CI [-0.36, -0.04]). DISCUSSION: Psychosocial UMIs had small to medium beneficial effects for both patients and their family members. Questions remain regarding what intervention components, modes of delivery, or dosages influence effect size. More rigorously designed randomized controlled trials are needed to validate intervention effects on patients' and family members' uncertainty management.

Use of Art-Making Intervention for Pain and Quality of Life Among Cancer Patients: A Systematic Review.

BACKGROUND: Although pain is one of the most prevalent symptoms among cancer patients, medications do not always result in sufficient pain relief. Furthermore, these medications only address the physical component of pain. Art making, a holistic approach, may distract the user's attention from pain and allow expression of the nonphysical (e.g., psychological, spiritual) components of pain. The purpose of this systematic review was to evaluate evidence for the efficacy of art-making interventions in reducing pain and improving health-related quality of life (QoL) among cancer patients. METHOD: PubMed, Academic Search Premier, ProQuest, and CINAHL were searched from database inception to September 2016 using the following search terms: neoplasm, cancer, tumor, pain, pain management, quality of life (QoL), well-being, art therapy, painting, and drawing. RESULTS: Fourteen articles reporting 13 studies were reviewed. Some studies reported beneficial effects of art making on pain and QoL, but the evidence was weakened by poor study quality ratings, heterogeneity in art-making interventions and outcome measures, interventions including non-art-making components, and few randomized controlled studies. CONCLUSION: More rigorous research is needed to demonstrate the efficacy of art making in relieving cancer-related pain and improving QoL.