A total of 10 studies were identified. When a study compared more than one intervention arm with the control arm, each intervention arm was labelled as a separate trial; this resulted in the authors stating that 13 trials (870 patients) had been included.
All studies used adequate methods of randomisation. Only 5 studies reported using adequate methods of allocation concealment, and only 7 reported adequate details of the numbers and reasons for participant withdrawals.
Emotional functioning - distress (10 trials).
A statistically significant beneficial effect of the intervention was found for anxiety (1 trial of behaviour therapy and social support), patient self-esteem (1 trial of behaviour therapy and social support) and depression (5 trials: one behaviour therapy; three behaviour therapy and social support; one counselling and behaviour therapy). No effect of individual counselling on death anxiety was found.
Emotional functioning - coping (6 trials).
Five trials (one counselling alone; two behaviour therapy alone; one counselling and behaviour therapy; and one behaviour therapy and social support) found a statistically significant beneficial effect of the intervention on the patients' coping abilities. Two trials found that individual behavioural therapy significantly improved a patient's perceived ability to control pain, while another found a significant reduction in patient denial.
Physical functioning (5 trials).
Two trials found that a nursing intervention for breathlessness significantly improved patient's distress relating to breathlessness, activity levels and functional abilities.
Global measures of QoL (5 trials).
Three trials (two behaviour therapy and one behaviour therapy and counselling) found the intervention significantly improved QoL on the Function Living Index (cancer) scale.