title: Effect of psychosocial interventions on outcomes of patients with colorectal cancer: a review of the literature.
abstract: OBJECTIVE
  Patients with colorectal cancer experience physical, psychological and social challenges. Psychosocial interventions seem to be effective in improving the physical, psychological and social outcomes of cancer patients. There is a lack of research exploring the effectiveness of pre-operative and post-operative psychosocial interventions on the outcomes of colorectal patients. This literature review aimed to explore the effects of pre-operative and post-operative psychosocial interventions on the outcomes of patients with colorectal cancer, including physical, psychological and social functioning, as well as the quality of life.
  
  
  METHODS
  A literature search for studies on psychosocial interventions for patients with colorectal cancer published between 2002 and 2012 was undertaken from electronic databases of Medline, CINAHL, Scopus, PsycINFO, Mednar, and Proquest. Hand-searching was conducted to find relevant papers from the reference lists of included articles.
  
  
  RESULTS
  Eleven studies met the inclusion criteria and were included after methodological quality appraisal. A narrative summary was carried out. Various psychosocial interventions, including educational interventions, cognitive-behavioural therapy, relaxation training and supportive group therapy were found to reduce colorectal patients' length of hospital stay, days to stoma proficiency and hospital anxiety and depression, and to improve patients' quality of life. Home visits, telephone sessions, individual teaching sessions and group sessions were commonly conducted.
  
  
  CONCLUSIONS
  Various forms of psychosocial interventions were used to improve outcomes of patients with colorectal cancer. Further research is recommended to investigate the effects of psychosocial interventions carried out during both the pre- and post-operative period on colorectal patients' outcomes. Given the small number of studies identified, it is essential to take this into consideration when identifying strategies and conducting future psychosocial interventions for colorectal patients.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: rain33320032003@hotmail.com.
authors.forename: Lim Siew
authors.initials: LS
authors.lastname: Hoon
authors.forename: Chan Wai
authors.initials: CW
authors.lastname: Chi Sally
authors.forename: He
authors.initials: H
authors.lastname: Hong-Gu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Anxiety; Cognitive-behavioural therapy; Colorectal cancer; Depression; Psychoeducational intervention; Psychosocial intervention; Quality of life; Relaxation training; Stoma proficiency; Support expressive group therapy