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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Communication, information and support for adults with malignant cerebral glioma: a systematic literature review

E Davies and IJ Higginson.

Review published: 2003.

CRD summary

This review assessed interventions for patients and their relatives. The authors concluded that the general principles by which cancer patients are cared for should be applied to patients with cerebral glioma. This conclusion may not be reliable because all included studies were observational and no evidence of effective interventions was found.

Authors' objectives

To establish the evidence for information, communication and support for adults with malignant cerebral glioma.

Searching

MEDLINE (1966 to May 2000), EMBASE (1988 to May 2000), CINAHL (1982 to March 2000), British Nursing Index (March 2000), Cancerlit (October 1999 to May 2000), the Cochrane Library (2000), PsycINFO (1966 to June 2000), Social Sciences Citation Index (March 2000), CareData (Feb 2000), ASSIA (March 2000) and HMIC (Feb 2000) were searched using the search terms listed in the review. In addition, three journals were handsearched: the Journal of Neuro-oncology (1996 to 2000), Journal of Psychosocial Oncology (1995 to 1998) and Psycho-oncology (1992 to 2000) were handsearched. The Cochrane Pain, Palliative Care and Supportive Care Group and neurological charities were contacted. The reference lists of identified articles were screened and further searches of authors and conference proceedings were performed. The studies had to be published in English.

Study selection

Study designs of evaluations included in the review

No inclusion criteria for the study design were pre-specified. The excluded study designs included historical reviews, personal views and expert consensus views. The studies needed to include the following outcome measures: patient or relative awareness of the diagnosis and prognosis; patient or relative satisfaction with information or care; patient or relative psychological distress; patient or relative uptake of new service or information; and professional communication skills.

Specific interventions included in the review

No specific inclusion criteria for the interventions were pre- specified. The interventions needed to relate to the reviews seven key questions.

What do patients and relatives understand of the diagnosis and prognosis?

What more do they wish to know?

Are some methods of breaking bad news more effective for these patients?

What are the best ways to make information available?

What needs for support do patients and relatives perceive after diagnosis and treatment?

Is there evidence for the role of the specialist nurse in providing information and support?

What educational interventions help staff break bad news, give information or provide support in malignant glioma?

Participants included in the review

Patients aged 18 years and older were eligible for inclusion. The studies needed to include some patients with malignant cerebral glioma. Studies of patients with other cancers or secondary brain cancer were excluded.

Outcomes assessed in the review

Studies that did not present subjective views from the patients or relatives were excluded.

How were decisions on the relevance of primary studies made?

The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.

Assessment of study quality

Separate quality checklists were used for quantitative and qualitative studies, based on study design and methodology. Quantitative studies were graded I, II, and III, while qualitative studies were graded as 'good', 'average' or 'poor'. The authors did not state how the papers were assessed for quality, or how many reviewers performed the quality assessment.

Data extraction

The authors did not state how the data were extracted for the review, or how many reviewers performed the data extraction.

Methods of synthesis

How were the studies combined?

The studies were combined according to which review question they answered.

How were differences between studies investigated?

Differences between the studies were discussed in the report.

Results of the review

Twelve observational studies were included in the review. The sample size ranged from 7 to 75 patients.

No studies investigated the effectiveness of methods for breaking bad news to patients. Equally, there were no studies reporting the effectiveness of different ways of providing other information to patients and relatives, e.g. leaflet, booklets, help lines or electronic sources.

Seven studies looked at the support needs of patients and relatives. The studies varied in focus. Two studies found positive outcomes for support groups for patients and the relatives of patients with malignant glioma.

There was some evidence of satisfaction with a specialist nurse who provides information and support to the patients. No studies of educational interventions used to help staff break bad news, give information or provide support in malignant cerebral glioma, were found.

Authors' conclusions

Few studies have considered the needs of patients and relatives of patients with malignant cerebral glioma, but the findings so far appear to be similar to those for lung cancer patients. This suggests that the general principles by which cancer patients are cared for should be applied to patients with malignant cerebral glioma.

CRD commentary

The review question was defined in terms of the participants and outcomes. The study design and intervention were not pre-specified and the review was not restricted to intervention studies. A range of databases was searched using a variety of search terms. However, the search strategy was restricted to studies published in English, which may have resulted in research being missed. There was no information on how the data were extracted and by how many reviewers; bias may be introduced to the findings if the studies were not selected and data extracted independently by more than one reviewer.

All twelve studies identified for inclusion were of an observational design. Hence, the review discussed emerging themes but could provide no evidence of effective interventions. The studies were quality assessed according to quantitative and qualitative criteria. This study highlights the need for trial investigation methods of providing information, communication and support to this patient group.

Implications of the review for practice and research

Practice: The authors stated that the method of communicating a prognosis to patients and relatives should be adapted depending on the coping style of the individual.

Research: The authors stated the need for research on educational interventions that assist staff in the delivery of bad news. Research should also focus on the best mix of health professionals to conduct patient follow-up and other possible means of support such as counselling. Studies that investigate the impact of cognitive differences in the comprehension of information would be useful to inform practice.

Bibliographic details

Davies E, Higginson I J. Communication, information and support for adults with malignant cerebral glioma: a systematic literature review. Supportive Care in Cancer 2003; 11(1): 21-29. [PubMed: 12527950]

Indexing Status

Subject indexing assigned by NLM

MeSH

Adult; Aged; Awareness; Brain Neoplasms /psychology /therapy; Communication; Databases, Factual; Glioma /psychology /therapy; Humans; Information Services; Middle Aged; Patient Education as Topic; Professional-Patient Relations; Social Support

AccessionNumber

12003000450

Database entry date

31/08/2004

Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 12527950

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