Effects of Psychosocial Interventions on Cortisol and Immune Parameters in Patients with Cancer: A Meta-analysis

Abstract

Purpose: This study was done to evaluate the effects of psychosocial interventions on cortisol and immune response in adult patients with cancer. Methods: MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and domestic electronic databases were searched. Twenty controlled trials (11 randomized and 9 non-randomized trials) met the inclusion criteria with a total of 862 participants. Methodological quality was assessed using the Cochrane's Risk of Bias for randomized studies and the Risk of Bias Assessment tool for non randomized studies. Data were analyzed using the RevMan 5.2.11 program of Cochrane library. Results: Overall, study quality was moderate to high. The weighted average effect size across studies was -0.32 (95% CI [-0.56, -0.07], p= .010, I 2 = 45%) for cortisol concentration, -0.62 (95%CI [-0.96,-0.29], p< .001, I 2 = 0%) for T lymphocyte (CD3) and -0.45 (95%CI [-0.74, -0.16], p= .003, I 2 = 0%) for Th lymphocyte (CD4) numbers. Psychosocial interventions were not effective for Tc lymphocyte (CD4), NK cell, monocyte, and cytokine response. Conclusion: Although these results provide only small evidence of successful immune modulation, they support the conclusion that psychosocial interventions can assist cancer patients in reducing emotional distress and improving immune response. If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

A Needs Analysis for the Development of Forest Healing Programs: Focusing on Cancer Patients

“…Depending on the stress level, the healthy group preferred walking in the forest, listening to the water, and experiencing the five senses, whereas the high-risk stress group pre-ferred cognitive programs such as lectures, counseling, and coaching (Kim, 2016a). Among factors that affect psychosocial adaptation of cancer patients, stress has a direct effect; thus, not only the process of curing cancer but also psychosocial adaptation to coping with the process is important (Oh and Jang, 2014). To increase the therapeutic effects for cancer patients, it is necessary to first develop forest healing programs that meet the purpose of the treatment by reflecting the specificity of cancer types.…”