A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers.

PURPOSE/OBJECTIVES: To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect. DESIGN: Randomized trial. SETTING: Community-based cancer helplines in Queensland and New South Wales, Australia. SAMPLE: 354 patients with cancer and 336 caregivers. METHODS: Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months. MAIN RESEARCH VARIABLES: Psychological and cancer-specific distress and post-traumatic growth. FINDINGS: No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64). CONCLUSIONS: Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support. IMPLICATIONS FOR NURSING: Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.

Systematic review of research into the psychological aspects of prostate cancer in Asia: what do we know?

BACKGROUND: To review the peer reviewed literature on the psychological aspects of the prostate cancer experience of men in Asia. MATERIALS AND METHODS: Medline and PsycINFO, CINAHL, ProQuest, and Web of Science (1999 - November Week 4, 2012) were searched. Inclusion criteria were: included men with prostate cancer and/or their partners or caregivers who identify as Asian recruited in an Asian country; and assessed health-related quality of life, psychological and social adjustment relating to prostate cancer and published in English after 1st January 1999 and prior to 30th November, 2012. Study aims; design; quality; level of evidence, and key results were assessed. RESULTS: 43 articles met all inclusion criteria and were retained for initial review. Of these most focussed on health-related QOL with only five evidence Level IV studies from Japan and Taiwan including a specific psychological focus. Of these, one was a cross-sectional case control study; three were cross- sectional descriptive quantitative designs; one was a cross-sectional descriptive qualitative study. From the data available, a substantive sub group of men with prostate cancer (approximately one third) in these countries experience clinically high psychological distress and decision regret. CONCLUSIONS: Research on the psychological needs of men with the increasingly prevalent condition of prostate cancer in Asian countries is scant with only a small number of low level evidence descriptive studies identified. Future research to underpin the development and evaluation of effective and culturally relevant psychological and supportive care interventions for such men is urgently needed.