title: A biopsychosocial perspective on adjustment and quality of life following brain tumor: a systematic evaluation of the literature.
abstract: OBJECTIVE
  To systematically evaluate the literature on quality of life and adjustment to brain tumor from a biopsychosocial perspective.
  
  
  METHODS
  On the basis of the cancer and brain injury literature, a biopsychosocial organisational framework was initially developed to support an evaluative review of the brain tumor literature. This framework consisted of four themes relating to pre-illness characteristics, neuropathology, personal appraisals and reactions and social support. Electronic searches of Medline, PsycINFO and CINAHL databases identified 48 empirical studies (1980-2007) that investigated factors associated with quality of life or the adjustment of adults with brain tumor. A review of studies within each theme appraised these findings and evaluated the quality of methodology and extent to which biopsychosocial perspectives have guided investigations.
  
  
  RESULTS
  Overall, the review identified consistent associations between depression, performance status, fatigue and quality of life. Seven multivariate studies with strong methodology that adopted a biopsychosocial perspective were found. In general, the relationships among pre-illness and brain tumor characteristics, psychosocial variables and quality of life were unclear and various gaps in the literature emerged.
  
  
  CONCLUSIONS
  Empirical findings within a biopsychosocial perspective may guide the development and delivery of support services for individuals with brain tumor; however, many important areas exist for future research.
authors.affiliation: School of Psychology and Applied Cognitive Neuroscience Research Centre, Griffith University, Brisbane, Australia. t.ownsworth@griffith.edu.au
authors.forename: Tamara
authors.initials: T
authors.lastname: Ownsworth
authors.forename: Anna
authors.initials: A
authors.lastname: Hawkes
authors.forename: Suzanne
authors.initials: S
authors.lastname: Steginga
authors.forename: David
authors.initials: D
authors.lastname: Walker
authors.forename: David
authors.initials: D
authors.lastname: Shum
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001932:Brain Neoplasms / Q000453:epidemiology / Q000534:rehabilitation*; D003863:Depression / Q000453:epidemiology; D005192:Family Health; D006801:Humans; D015994:Incidence; D011788:Quality of Life; D012917:Social Adjustment; D012944:Social Support