A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer

Our plain-English summary of A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer, by H. Ball, S. Moore, A. Leary (European Journal of Oncology Nursing, 2016).

The study

• Authors: H. Ball, S. Moore, A. Leary
• Journal: European Journal of Oncology Nursing
• Published: 2016;25:62-67
• Type of article: Systematic review
• Cited by: 45 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: Psychological distress which adversely affects a person's experience of cancer has been shown to be highly prevalent in patients with mesothelioma. Historically, the assumption has been made that the evidence guiding the supportive care needs for lung cancer is relevant to those with mesothelioma. The objective of the study was to evaluate if the psychological care needs differ between patients with pleural mesothelioma and those with advanced lung cancer.

Methods: A search of MEDLINE, CINAHL, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO databases, grey literature and the Cochrane Library of Systematic Reviews identified 17 studies meeting a predefined inclusion criteria. These were critically appraised for quality. Data relating to psychological experiences was extracted which was then synthesised narratively and through a process of meta ethnography.

Results: Common themes identified across the studies created 10 key concepts. These were uncertainty, normality, hope/hopelessness, stigma/blame/guilt, family/carer concern, physical symptoms, experience of diagnosis, iatrogenic distress, financial/legal and death and dying. Key similarities and differences were identified between the mesothelioma and lung cancer evidence.

Conclusions: There is limited research exploring the lived experiences of those with mesothelioma and lung cancer, with the majority of them having methodological and/or reporting concerns compromising the conclusions made. However, reoccurring themes in the evidence were found suggesting a number of areas where the psychological experience of mesothelioma differs from that of advanced lung cancer. These findings warrant further research to explore further and if proven, the need for the provision of specialist mesothelioma care services is affirmed.

Copyright © 2016 Elsevier Ltd. All rights reserved.

In plain English

This was a systematic review of earlier research, not a new study of patients. The authors searched databases and other sources for qualitative studies of the psychological experiences of adults with pleural mesothelioma or advanced lung cancer. They excluded studies with serious quality concerns. Seventeen studies were included: eight involving mesothelioma and twelve involving lung cancer, three of them covering both. The authors identified ten themes, including uncertainty, hope or hopelessness, blame and stigma, and financial and legal matters. Hopelessness was a theme in three mesothelioma studies, while hope was a theme in five lung cancer studies. Financial and legal matters caused distress in all the mesothelioma studies but in only one lung cancer study. In three mesothelioma studies, patients blamed a former employer for exposing them to asbestos. In three lung cancer studies, patients reported stigma linked to smoking. The authors concluded that some sources of distress seem distinct for mesothelioma. They said this conclusion was weakened by limited research, by samples drawn mostly from patients receiving treatment, and by having a single analyst.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Systematic literature review of qualitative and mixed-method studies, with the findings combined by meta ethnography
• Who was studied: 17 published studies (searches run in March 2013 and repeated in May 2016). Eight included people with pleural mesothelioma and twelve included people with advanced lung cancer; three included both groups.
• Exposure: No fiber exposure was measured. The review compared the psychological experiences of adults diagnosed with pleural mesothelioma with those of adults with advanced lung cancer.
• Main results:
  • Across the 17 studies, the authors identified ten key concepts or themes affecting the psychological wellbeing of patients with mesothelioma and lung cancer.
  • Hopelessness was identified as a theme in three mesothelioma studies, linked to the incurable disease, limited prognosis and lack of effective treatments. Hope was identified as a theme in five lung cancer studies.
  • Financial and legal matters were a source of distress in all the mesothelioma studies but in only one lung cancer study.
  • In three mesothelioma studies, individuals felt anger and betrayal because they blamed a former employer for exposing them to asbestos.
  • In three lung cancer studies, individuals reported stigma because of the disease's association with smoking.
  • In the mesothelioma studies, two studies identified the timing of information about potential compensation and benefit claims as a cause of distress.
  • Distress caused by contact with the health care system was identified in 15 of the 17 studies.
  • Uncertainty affected psychological wellbeing in four mesothelioma studies and seven lung cancer studies.
• The authors' conclusion: The authors concluded that the two groups share some causes of psychological distress, but that other factors seem distinct for people with mesothelioma. They called for separate assessment and care pathways, while stating that their conclusions are tentative and need further investigation.
• Limitations the authors state:
  • Few primary research studies were found in this area.
  • Participants were drawn mainly from hospital patients receiving or who had received treatment, who may be fitter than others. This selection bias limits how widely the findings apply.
  • Two of the mesothelioma-focused studies involved Australian populations, which raises questions about their relevance to the UK.
  • The views of carers and family members were excluded.
  • Data extraction and analysis were done by a single analyst, which increases the risk of interpretational bias.
  • The research grew out of the author's clinical experience, so prior conceptions may have biased the process.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Systematic Review, Mesothelioma, Lung Cancer, Pleural Mesothelioma.

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