Psychological treatment for family members of children with cancer: A systematic review and meta-analysis

Objective This meta-analytical study examined the effects of psychological treatments applied to family members of children and adolescents with cancer, as well as the characteristics of the studies that can be associated with their effects. Methods Four databases were searched between January 1980 and January 2017; the references of the located studies were reviewed, and emails were sent to experts in this topic. Forty articles fulfilled the selection criteria. The standardized mean pretest-posttest (or pretest-follow-up) change was used as the effect-size index for the treatment and control groups. Results The 40 articles included 40 treatment groups and 21 control groups. When treatment and control pretest-posttest mean effects were compared, psychological interventions revealed positive, statistically significant results for anxiety (d(adj) = 0.339) and problem-solving skills (d(adj) = 0.385) and, to a lesser extent, for posttraumatic stress (d(adj) = 0.224). No statistically significant differences were found for mood (d(adj) = 0.147), acute stress (d(adj) = -0.010), coping skills (d(adj) = 0.123), social support (d(adj) = 0.245), or quality of life (d(adj) = 0.538). Conclusions Positive effects of mild to moderate magnitude were found in the posttests for some outcome measures. Behavioral interventions seem to be the most promising. Interventions achieved the best results when they were long in duration and low in intensity and when they were applied to family members with young children who were undergoing medical treatment. At follow-up, the intervention benefits were diminished. The application of psychological interventions is recommended to mitigate the negative psychological repercussions in this population.