Abstract
Purpose This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice
(PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP
alone or (4) BGA alone in cancer patients and survivors (CPaS).
Methods PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP
in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating
symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to
6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach.
Results Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity
of PIP + BGA comparing to WLC were found for anxiety (SMD − 1.29 [−1.71; − 0.86]), depression (SMD − 0.79
[− 1.10; − 0.48]), functional impairment (SMD − 0.72 [− 0.95; − 0.50]), PA (self-reported: (SMD − 0.58 [− 0.84; − 0.32])
and objectively measured: (SMD − 0.51 [− 0.90; − 0.13])) and social impairment (SMD − 0.33 [− 0.58; − 0.08]). When comparing
PIP + BGA to OI, fatigue (SMD − 0.35 [− 0.51; − 0.20]) and PA (SMD − 0.26 [− 0.41; − 0.11]) at PI, and fatigue
(SMD − 0.34 [− 0.58; − 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in
the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone.
Conclusions PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions
such as WLC, usual care and education. However, further research is needed on ‘how’ and ‘when’ PIP + BGA should
be provided in cancer rehabilitation.
Implications for Cancer Survivors PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA
and reduce DS.
| Original language | English |
|---|---|
| Pages (from-to) | 854-899 |
| Number of pages | 46 |
| Journal | Journal of Cancer Survivorship |
| Volume | 18 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 2024 |
Bibliographical note
Funding Information:AL is a research fellow funded by the Research Foundation Flanders (FWO), Belgium (grant number 11B1920N). ER is funded by Stand Up To Cancer (Kom op tegen Kanker — KOTK), a Belgian cancer charity (project code ANI251). LL is a postdoctoral research fellow appointed on two funded projects, one by the Research Foundation Flanders (FWO) (grant number G040919N) and one by Stand up to Cancer (Kom op tegen Kanker (KOTK) — project code ANI251). JN is holder of a chair on oncological rehabilitation funded by the Berekuyl Academy/European College for Decongestive Lymphatic Therapy, the Netherlands.
Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023.
Keywords
- Adverse effects · Behaviour therapy · Exercise · Meta-analysis · Neoplasms · Quality of life