Meta-analysis of moderators of psycho-oncology therapy effectiveness : "it's the sick who need a doctor" : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

Heron, Heather Adele

Meta-analysis of moderators of psycho-oncology therapy effectiveness : "it's the sick who need a doctor" : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

dc.contributor.author	Heron, Heather Adele
dc.date.accessioned	2010-09-28T00:19:16Z
dc.date.available	NO_RESTRICTION	en_US
dc.date.available	2010-09-28T00:19:16Z
dc.date.issued	2009
dc.description.abstract	Reviews conflict regarding the effectiveness of psycho-oncological therapies at reducing patient anxiety, depression and general distress, suggesting that unknown factors are moderating trial results. This meta-analysis investigates the moderating impact of a large range of socio-demographic, psychological, medical and therapy factors using published and unpublished data from 146 prospective controlled trials, including non-random designs. Preliminary analyses of trial design quality features exposed 2 moderators: recruit screening for psychological distress or history, and the nature of the control condition. These structured a 2 x 2 matrix used to conduct substantive analyses. Admitting only recruits with established baseline distress was found to predict greater effect size, as was excluding patients with a history of distress. Main effects for patients with baseline distress compared with untreated controls, were medium-strong at g = 0.52 - 0.70. Evidence of varying strengths indicated that patients who were older, of lower income, male, single, or suffering from cancer sited elsewhere than breast produced higher effect sizes. Data also highlighted particular stages in the cancer journey: re-entry to normal life at the end of medical treatment, recurrence, and distant disease spread. Findings suggest that risk and distress screening should be employed by both clinicians and researchers. Researchers should also re-direct attention away from unscreened middle class early stage breast cancer patients, towards more vulnerable socio-demographic and medical groups. The potential of using survivors and indirect therapies to effectively and efficiently reach vulnerable groups deserves exploration. Reviewers need to take into account the 2 trial design moderators discovered, and should include non-random controlled trials which may have more access to particularly vulnerable groups because some past conclusions were confounded by the co-variation of study design with sampling characteristics.	en_US
dc.identifier.uri	http://hdl.handle.net/10179/1707
dc.language.iso	en	en_US
dc.publisher	Massey University	en_US
dc.rights	The Author	en_US
dc.subject	Cancer patients	en_US
dc.subject	Psychotherapy	en_US
dc.subject	Psycho-oncology therapy	en_US
dc.subject.other	Fields of Research::380000 Behavioural and Cognitive Sciences::380100 Psychology::380107 Health, clinical and counselling psychology	en_US
dc.title	Meta-analysis of moderators of psycho-oncology therapy effectiveness : "it's the sick who need a doctor" : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand	en_US
dc.type	Thesis	en_US
massey.contributor.author	Heron, Heather Adele
thesis.degree.discipline	Psychology	en_US
thesis.degree.grantor	Massey University	en_US
thesis.degree.level	Masters	en_US
thesis.degree.name	Master of Arts (M.A.)	en_US