Reduced patient anxiety as a result of radiation therapist-led psychosocial support: a systematic review

Abstract

Up to 49% of patients attending radiation therapy appointments may experience anxiety and distress. Anxiety is heightened during the first few visits to radiation oncology. Radiation therapists (RT) are the only health professionals in direct daily contact with patients during treatment, placing them in a unique position to explore patients’ psychosocial needs. This review aims to synthesise literature regarding the effect of RT‐led psychosocial support on patient anxiety. In May 2015, we searched the following electronic databases: Medline, PsycINFO, Embase, CINAHL, PubMed and Cochrane library. Radiation therapy‐specific journals were hand‐searched, and reference lists of identified studies searched. This review complies with Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. The search identified 263 articles, of which 251 were excluded based on non‐English language, duplicate article or relevance. A total of 12 articles involving 1363 patients were included and categorised into three broad themes: ‘Patient Perspectives’ 3 articles, ‘Patient Information and Education’ 5 articles and ‘Screening and Needs Assessment’ 4 articles. Two publications referred to the same sample and data. Quality ratings were mixed, with one study rated ‘high’ quality, seven ‘moderate’ and four ‘low’. Methodological weaknesses were identified in relation to workflow, sample size and responder bias. RTs have a role in psychosocial support through increased communication and information sharing, which can benefit both patients and staff. RT‐led practices such as relationship building, patient education sessions and screening and needs assessments are feasible and can reduce anxiety.

Development and pilot of an international survey: ‘Radiation Therapists and Psychosocial Support’

“…The ‘RTs and Psychosocial Support Survey’ instrument was developed to address gaps in the literature regarding provision of psychosocial support in the radiation oncology setting (Table ). Existing items were embedded and literature‐guided survey development to ensure data could be compared.…”

“…The review indicated RTs do provide daily supportive care that can reduce anxiety, fear and loneliness. To achieve this, RTs build rapport with patients and provide emotional comfort, information and education . RT use of screening and needs assessment tools was shown to be feasible and resulted in increased communication and knowledge of patients’ psychosocial concerns .…”

“…RT use of screening and needs assessment tools was shown to be feasible and resulted in increased communication and knowledge of patients’ psychosocial concerns . RT motivation to use screening tools varied, but training appeared to increase RT co‐operation …”

Psychological stress affects the severity of radiation-induced acute skin reactions in breast cancer patients

“…A recent meta-analysis by Elsner, Naehrig, Halkett, and Dhillon (2017) reviewed the effectiveness of psychosocial support provided by radiation therapists on patient anxiety levels in 12 studies comprising 1,363 patients. A recent meta-analysis by Elsner, Naehrig, Halkett, and Dhillon (2017) reviewed the effectiveness of psychosocial support provided by radiation therapists on patient anxiety levels in 12 studies comprising 1,363 patients.…”

Radiation therapy patient education using VERT: combination of technology with human care

“…Patient education is known to be a vital element of providing high quality care in radiation therapy (RT) . Effective patient education has positive impacts on patient consent, collaboration during treatment, patients’ empowerment and psychosocial well‐being . However, ‘radiation’ and the processes of RT are known to be difficult concepts for patients to understand, due to the complex nature of radiation as both a therapy and a danger, and a wide array of learner factors due to the diversity of cancer patient presentations, health literacy and competency in the local language …”