title: [Effects of psychosocial interventions on cortisol and immune parameters in patients with cancer: a meta-analysis].
abstract: OBJECTIVE
  This study was done to evaluate the effects of psychosocial interventions on cortisol and immune response in adult patients with cancer.
  
  
  METHODS
  MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and domestic electronic databases were searched. Twenty controlled trials (11 randomized and 9 non-randomized trials) met the inclusion criteria with a total of 862 participants. Methodological quality was assessed using the Cochrane's Risk of Bias for randomized studies and the Risk of Bias Assessment tool for non randomized studies. Data were analyzed using the RevMan 5.2.11 program of Cochrane library.
  
  
  RESULTS
  Overall, study quality was moderate to high. The weighted average effect size across studies was -0.32 (95% CI [-0.56, -0.07], p=.010, I²=45%) for cortisol concentration, -0.62 (95%CI [-0.96,-0.29], p<.001, I²=0%) for T lymphocyte (CD3) and -0.45 (95%CI [-0.74, -0.16], p=.003, I²=0%) for Th lymphocyte (CD4) numbers. Psychosocial interventions were not effective for Tc lymphocyte (CD4), NK cell, monocyte, and cytokine response.
  
  
  CONCLUSIONS
  Although these results provide only small evidence of successful immune modulation, they support the conclusion that psychosocial interventions can assist cancer patients in reducing emotional distress and improving immune response.
authors.affiliation: Department of Nursing, Sahmyook University, Seoul, Korea. ohpj@syu.ac.kr.
authors.forename: Pok Ja
authors.initials: PJ
authors.lastname: Oh
authors.affiliation: Department of Nursing, Graduate School, Sahmyook University, Seoul, Korea.
authors.forename: Eun-su
authors.initials: ES
authors.lastname: Jang
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology; D016207:Cytokines / Q000378:metabolism; D016208:Databases, Factual; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007694:Killer Cells, Natural / Q000166:cytology / Q000276:immunology; D009000:Monocytes / Q000166:cytology / Q000276:immunology; D009369:Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D011613:Psychotherapy; D013601:T-Lymphocytes / Q000166:cytology / Q000276:immunology*
chemical_list: D016207:Cytokines; D006854:Hydrocortisone
keywords: Cortisol; Immune; Intervention studies; Meta-analysis; Neoplasm