Psychological interventions for individuals with cystic fibrosis and their families

• Published in: Cochrane database of systematic reviews 2014-06, Vol.2014 (6), p.CD003148
• Main Authors: Goldbeck, Lutz, Fidika, Astrid, Herle, Marion, Quittner, Alexandra L
• Format: Article
• Language: English
• Subjects: Adult; Caregivers - psychology; Child; Child health; CYSTIC FIBROSIS; Cystic Fibrosis - psychology; Cystic Fibrosis - therapy; Diet - psychology; Family; Family Therapy - methods; Genetic disorders; Humans; Lungs & airways; Patient Compliance - psychology; Psychotherapy - methods; Randomized Controlled Trials as Topic; Respiratory Therapy - psychology
• ISSN: 1469-493X; 1469-493X
• DOI: 10.1002/14651858.CD003148.pub3

With increasing survival estimates for individuals with cystic fibrosis, long-term management has become an important focus. Psychological interventions are largely concerned with adherence to treatment, emotional and social adaptation and health-related quality of life. We are unaware of any relevant systematic reviews. To determine whether psychological interventions for people with cystic fibrosis provide significant psychosocial and physical benefits in addition to standard medical care. Studies were identified from two Cochrane trials registers (Cystic Fibrosis and Genetic Disorders Group; Depression, Anxiety and Neurosis Group), Ovid MEDLINE and PsychINFO; unpublished trials were located through professional networks and Listserves. Most recent search of the Cystic Fibrosis and Genetic Disorders Group's register: 19 December 2013.Most recent search of the Depression, Anxiety and Neurosis Group's register: 12 November 2013. Randomised controlled studies of a broad range of psychological interventions evaluating subjective and objective health outcomes, such as quality of life or pulmonary function, in individuals of all ages with cystic fibrosis and their immediate family. We were interested in psychological interventions, including psychological methods within the scope of psychotherapeutic or psychosomatic mechanism of action (e.g. cognitive behavioural, cognitive, family systems or systemic, psycho-dynamic, or other, e.g. supportive, relaxation, or biofeedback), which were aimed at improving psychological and psychosocial outcomes (e.g. quality of life, levels of stress or distress, psychopathology, etc.), adaptation to disease management and physiological outcomes. Three authors were involved in selecting the eligible studies and two of these authors assessed their risk of bias. The review includes 16 studies (eight new studies included in this update) representing data from 556 participants. Studies are diverse in their design and their methods. They cover interventions with generic approaches, as well as interventions developed specifically to target disease-specific symptoms and problems in people with cystic fibrosis. These include cognitive behavioural interventions to improve adherence to nutrition or psychosocial adjustment, cognitive interventions to improve adherence or those associated with decision making in lung transplantation, a community-based support intervention and other interventions, such as self-hypnosis, respiratory muscle bi