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Table 2 Psychologist-delivered interventions

From: Interventions to improve quality of life (QOL) and/or mood in patients with head and neck cancer (HNC): a review of the evidence

Study Settings/Patients Study Design/Intervention Timing of intervention Assessment timepoints Measures Results Methodological Quality
Hammerlid et al. (1999) [20] 13 HNC pts. in Sweden Single arm studies. Two studies: first, long term psychological group therapy for patients with newly diagnosed HNC with psychologist. Second, 1 week long psychoeducational program 1 year after treatment for HNC with oncologist, nurse, and physiotherapist. 1. Started with new diagnosis of HNC; 2. Started 1 year after treatment baseline, 1, 2, 3, 6, and 12 months HADS; EORTC; study-specific questionnaire QOL in therapy group improved more than control 3
Allison PJ et al. (2004) [21] 50 HNC pts.; Canada Single arm study. Intervention group received Nucare coping strategies, psychoeducational intervention that teaches coping in one of three formats (small group with therapist, one on one with therapist, or a home format without therapist) no information about where patients were in treatment or type of treatment or subtype of HNC baseline and 3 months EORTC-QOL; HADS Intervention resulted in higher health related QOL and depression scores. 5
Kangas et al. (2013) [22] 35 HNC pts. with elevated levels of PTSD, depression, or anxiety RCT. Intervention group received seven weekly individual sessions with clinical psychologist of multi-modal CBT vs non-directive supportive counseling, concurrent with patient’s radiotherapy. concurrent with radiotherapy baseline, 1, 6, and 12 months Clinician Administered PTSD Scale; Beck Depression Inventory; State Trait Anxiety Inventory; FACT-General CBT and SC interventions found to be equal in effects reducing PTSD and anxiety symptoms in short/long term. However, more pts. in CBT program no longer met clinical or sub clinical PTSD, anxiety, and/or depression by 12 months post treatment 5
Kilbourn et al. (2013) [28] 24 HNC pts. Single arm study. Easing and Alleviating Symptoms during Treatment (EASE) intervention – participants received up to 8 telephone counseling sessions focused on coping and stress management. Concurrent with radiotherapy Baseline, 1 month post intervention end Impact of Events Scale, FACT-HN, Pain Disability Index, Interpersonal Support Evaluation List Intervention was feasible and acceptable. Participants experienced decrease in QOL and no change in pain scores. 4
Krebber et al. (2016) [23] 156 pts. (HNC and lung cancer (LC)); had distress on HADS to be included; Netherlands RCT. Intervention group received stepped care, which consisted of watchful waiting, guided self-help, problem-solving therapy, and psychotherapy and/or psychotropic medication with oncologist or psychologist/psychiatrist as stepped care. enrolled within 1 month of completing curative treatment for LC or HNC (94%), no specifics on surgery vs. RT vs CRT baseline, completion of care, 3, 6, 9, 12 months HADS; EORTC QLQ-C30, QLQ-HN35/QLQ-LC13, IN-PATSAT32 (satisfaction with care) Psychological distress better in the stepped care group vs usual care. Those patients with anxiety or depression had an even larger improvement in the stepped care group. 6
Pollard et al. (2017) [29] 19 HNC pts. Single arm study. Mindfulness intervention – participants received 7, 90 min one-on-one sessions with clinical psychologist with individualized mindfulness-based stress reduction (IMBSR) program. Concurrent with radiotherapy Baseline and post-intervention/ treatment Five-Factor Mindfulness Questionnaire (FFMQ), Profile of Mood States-Short Form, FACT-HN Intervention was feasible and acceptable with good patient-compliance. QOL declined over the intervention for the whole population, however, patients with higher post-intervention mindfulness had higher QOL. 4