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      Effectiveness of palliative care interventions offering social support to people with life‐limiting illness—A systematic review

      review-article
      , BSc, MSc 1 , , , FRCP MD FRCHP MMedSci ILTM 1 , , BA MSc MD CQSW FRCGP FFPHM 1
      European Journal of Cancer Care
      John Wiley and Sons Inc.
      day care, group interventions, palliative care, psychosocial care, Social support, systematic review

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          Abstract

          Individuals managing the challenges of life‐limiting illness require adequate social support to maintain quality of life. Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies. This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support. Research literature was systematically searched using electronic databases and key journals. Searches returned a total of 6,247 unique titles of which sixteen were eligible for inclusion. Interventions include group therapies, group practical interventions and palliative day care. Outcome measures and study designs were heterogeneous. Only one study used a validated outcome measure of social support. Benefits were influenced by participant characteristics such as baseline distress. Partial economic evaluation was attempted by two studies. Methodological challenges include attrition and use of outcome measures that were insensitive to change. Statistically significant results were reported in psychological and physical domains. Evidence is limited due to methodological issues and a scarcity of quantitative research, particularly regarding long‐term benefits and cost‐effectiveness. Interventions may be more beneficial to some groups than others.

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          Most cited references59

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          The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients.

          A 14-item, self-administered, multidimensional, functional social support questionnaire was designed and evaluated on 401 patients attending a family medicine clinic. Patients were selected from randomized time-frame sampling blocks during regular office hours. The population was predominantly white, female, married, and under age 45. Eleven items remained after test-retest reliability was assessed over a 1- to 4-week follow-up period. Factor analysis and item remainder analysis reduced the remaining 11 items to a brief and easy-to-complete two-scale, eight-item functional social support instrument. Construct validity, concurrent validity, and discriminant validity are demonstrated for the two scales (confidant support--five items and affective support--three items). Factor analysis and correlations with other measures of social support suggest that the three remaining items (visits, instrumental support, and praise) are distinct entities that may need further study.
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            EFFECT OF PSYCHOSOCIAL TREATMENT ON SURVIVAL OF PATIENTS WITH METASTATIC BREAST CANCER

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              Perceived social support and coping responses are independent variables explaining pain adjustment among chronic pain patients.

              The purpose of the present study was to test a hypothetical model of the relationships between perceived social support, coping responses to pain, pain intensity, depressed mood, and functional disability (functional status and functional impairment) in a population of patients with chronic pain in a Spanish Clinical Pain Unit. It was postulated that social support and pain coping responses both independently influence reported pain intensity, depressed mood, and functional disability. Analyses were performed by Structural Equation Modelling. The results indicated that satisfaction with social support is significantly associated with a depressed mood and pain intensity, but not with functional disability. Although this effect is independent of the use of active coping responses by patients, there is a modest but significant relationship between social support and passive coping strategies, indicating that higher levels of perceived social support are related to less passive pain coping strategies. The findings underscore the potential importance of psychosocial factors in adjustment to chronic pain and provide support for a biopsychosocial model of pain. This article tested a hypothetical model of the relationships between social support, pain coping, and chronic pain adjustment by using Structural Equation Modelling. The results indicate that perceived social support and pain coping are independent predictors of chronic pain adjustment, providing support for a biopsychosocial model of pain.
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                Author and article information

                Contributors
                Role: PhD Studentnatasha.bradley@liverpool.ac.uk
                Role: Professor, Honorary Consultant in Palliative Medicine
                Role: Professor, Professor of Primary Medical Care
                Journal
                Eur J Cancer Care (Engl)
                Eur J Cancer Care (Engl)
                10.1111/(ISSN)1365-2354
                ECC
                European Journal of Cancer Care
                John Wiley and Sons Inc. (Hoboken )
                0961-5423
                1365-2354
                24 March 2018
                May 2018
                : 27
                : 3 ( doiID: 10.1111/ecc.2018.27.issue-3 )
                : e12837
                Affiliations
                [ 1 ] Academic Palliative and Supportive Care Studies Group Institute of Psychology Health and Society University of Liverpool Liverpool UK
                Author notes
                [*] [* ] Correspondence

                Natasha Bradley, Academic Palliative and Supportive Care Studies Group, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK.

                Email: natasha.bradley@ 123456liverpool.ac.uk

                Author information
                http://orcid.org/0000-0003-0768-9819
                Article
                ECC12837
                10.1111/ecc.12837
                6001732
                29573500
                178dda25-cfba-4803-9aac-edc022fed52e
                2018 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 February 2018
                Page count
                Figures: 1, Tables: 1, Pages: 12, Words: 8824
                Funding
                Funded by: Economic & Social Research Council
                Award ID: ES/J500094/1
                Categories
                Feature and Review Paper
                Feature and Review Paper
                Custom metadata
                2.0
                ecc12837
                May 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.1.1 mode:remove_FC converted:14.06.2018

                Oncology & Radiotherapy
                day care,group interventions,palliative care,psychosocial care,social support,systematic review

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