Cancer is greatly feared, difficult and complex to manage, and costly--both emotionally and financially. An estimated 7.1 million Americans have been diagnosed with cancer in the past 20 years and have had to face coping with the disease, its treatment, and living with its aftermath. Advances in cancer treatment have brought psychosocial challenges for patients such as increased involvement in treatment decisions, coping with side effects, and living as cancer survivors. Accordingly, more attention is currently paid to the quality of life of individuals with cancer. The rapid growth of inquiry in this area makes the systematic review of this research important and timely. The proposed project aims to address key questions regarding psychosocial interventions for cancer patients using systematic and meta-analytic review techniques. These techniques are useful in making sense of accumulated study findings and in identifying remaining research questions. The specific goals are (1) to elucidate the mechanisms by which psychosocial interventions for cancer patients may foster improvements in quality of life; (2) to determine the effects of specific treatment ingredients comprising interventions for individuals coping with cancer; (3) to clarify mixed results regarding the effects of psychosocial interventions on length of survival in individuals with cancer; (4) to determine if previously-documented benefits of psychosocial interventions tested in randomized (efficacy) trials hold for non-randomized (effectiveness) trials delivered in community settings; and (5) to identify which populations and types of interventions have been thoroughly studied and which have been overlooked. A thorough survey of the published and unpublished literature will be undertaken. A number of different channels will be used to ensure an exhaustive search. Each eligible study will be coded with respect to a number of features related to: the setting of the study, participants, methodology, and characteristics of the intervention. Coding procedures will be rigorously developed and maintained to maximize validity and reliability. Study outcomes will be expressed in terms of effect sizes, a standardized metric that allows aggregation of the magnitude and direction of results across studies. Where appropriate, moderator analyses of the influence of study level variables on outcomes will be performed. Integration and reevaluation of this work will help us to understand how psychosocial interventions work and how they can be improved.
