Effectiveness of Cognitive Behavioral Therapy Techniques for Control of Pain in Lung Cancer Patients: An Integrated Review


Background: Experience of lung cancer includes negative impacts on both physical and psychologicalhealth. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are oftenrecommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence onthe effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review consideredstudies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and readEnglish or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring anopioid medication; 5) have a positive response to opioid medication; 6) have “average or usual” pain between 4and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a painevaluation and treatment program. This review considered studies to examine interventions for use in treatmentof pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, andmeditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniquesfor pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designswere reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity beforeand after cognitive behavioural therapy techniques. The search strategy aimed to find both published andunpublished literature. A three-step search was utilised by using identified keywords and text term. An initiallimited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained inthe title and abstract, and of the index terms used to describe the article. A second search using all the identifiedkeywords and index terms was then undertaken across all included databases. Thirdly, the reference list of allidentified reports and articles were searched for additional studies. Searches were conducted during January1991- March 2014 limited to English and Thai languages with no date restriction. Materials and
Methods:All studies that met the inclusion criteria were assessed for methodological quality by three reviewers usinga standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted dataindependently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally forquantitative data meta-analysis was to be conducted where all results were subject to double data entry. Oddsratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidenceintervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square.Where statistical pooling was not possible the finding were be presented in narrative form.
Results: There wereno studies located that met the inclusion requirements of this review. There were also no text and opinion piecesthat were specific to cognitive behavioral therapy techniques pain and lung cancer patients.
Conclusions: Thereis currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques forpain in lung cancer patients.