Are self-administered psychosocial interventions as efficacious as guided interventions in the management of chronic health conditions? — ASN Events
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Are self-administered psychosocial interventions as efficacious as guided interventions in the management of chronic health conditions? (#296)

Sylvie Lambert 1 , Lisa Beatty 2 , Patrick McElduff 3 , Janelle Levesque 4 , Catalina Lawsin 5 , Jane Turner 6 , Paul Jacobsen 7 , Afaf Girgis 8
  1. McGill University, Montreal , Canada
  2. Flinders University , Adelaide
  3. University of Newcastle, Newcastle
  4. University of New South Wales/Ingham Institute, LIVERPOOL BC, NSW, Australia
  5. University of Sydney , Sydney
  6. University of Queensland , Brisbane
  7. Moffitt Cancer Centre , Tampa
  8. University of New South Wales/Ingham Institute , LIVERPOOL, NSW, Australia

Background: While it is acknowledged that psychosocial interventions can improve the quality of life (QOL) of individuals with a physical illness; they are often not routinely part of supportive care, potentially due to costs and issues relating to long-term sustainability.

 

Aim: To assess the efficacy of self-administered, psychosocial interventions to improve outcomes among individuals with a physical illness (including individuals with cancer).

 

Methods: Eligible studies comparing a self-administered intervention to a control group were identified through search of the CINAHL, MEDLINE, PsychINFO and Web of Knowledge databases and secondary searches of reference lists.  Random effects meta-analyses were performed separately for the primary (anxiety, depression) and secondary (distress, QOL, self-efficacy, coping) outcomes.

 

Results: The search yielded 24 manuscripts that met the eligibility criteria for inclusion. The standard mean difference (SMD) was significant for anxiety (SMD= - 0.13, 95%CI= - 0.25 to - 0.01), depression (SMD=- 0.27, 95%CI= - 0.38 to - 0.16), distress (SMD= - 0.20, 95%CI= - 0.37 to - 0.04), global (SMD= 0.25, 95%CI= 0.06 to 0.44) and disease-specific (SMD= -0.18, 95%CI= - 0.31 to - 0.05) QOL, and self-efficacy (SMD= 0.54, 95%CI= 0.34 to 0.73). Non-significant results were found for mental, physical, and social functioning and coping.

 

Conclusions: Self-administered interventions are a potentially efficacious and cost-effective approach to address some of the most common supportive care needs of patients with cancer, especially anxiety, depression and distress. Future studies need to compare the efficacy and cost-effectiveness of different levels of guidance directly, and the potential impact of tailoring these interventions to individuals’ needs.

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