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

암 환자에게 적용한 심리사회적 중재가 코티졸과 면역기능에 미친 효과: 메타분석

  • Oh, Pok Ja (Department of Nursing, Sahmyook University) ;
  • Jang, Eun-Su (Department of Nursing, Graduate School, Sahmyook University)
  • 오복자 (삼육대학교 간호학과) ;
  • 장은수 (삼육대학교 대학원 간호학과)
  • Received : 2014.03.25
  • Accepted : 2014.07.03
  • Published : 2014.08.29

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.

Keywords

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