A systematic review of psychological interventions for patients with head and neck cancer

Support Care Cancer. 2019 Jun;27(6):2007-2021. doi: 10.1007/s00520-019-04768-3. Epub 2019 Apr 1.

Abstract

Aim: The purpose of this systematic review is to identify psychological interventions that have been effective at improving quality of life and reducing psychological distress (depression and anxiety) in patients with head and neck cancer.

Methods: All relevant peer-reviewed articles published between March 1980 and March 2017 were identified through an electronic search of five databases: Medline, Embase, PsycINFO, Scopus, and Academic Search Complete. Risk of bias was independently assessed by two reviewers using the Crowe Critical Appraisal Tool (CCAT). Following this, a narrative synthesis of the findings was completed.

Results: Twenty-one unique intervention studies were identified. Interventions tested included cognitive behavioural therapy (CBT), psychoeducation, meditation/mindfulness, group therapy, and telehealth initiatives. Ten studies utilised a randomised controlled design. Five of these investigated CBT and three examined psychoeducation, with the greatest empirical support found for these intervention types. However, the majority of studies were underpowered to detect significant effects and did not examine whether improvements in quality of life and psychological well-being were sustained over time.

Conclusions: Further research is needed to investigate the effects of psychological interventions among patients with head and neck cancer, using randomised controlled designs, adequately powered samples, and long-term follow-up. This would allow evidence-based recommendations to be made regarding the most appropriate interventions to implement in clinical practice.

Trial registration: CRD42017069851.

Keywords: Anxiety; Depression; Head and neck cancer (HNC); Health-related quality of life (HRQL); Psychological intervention; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / psychology*
  • Humans
  • Quality of Life / psychology*