Evidence map›Paper›PMID 36284042›Full record

SynthesisInternational journal of behavioral medicine2023

Experiential Avoidance in Advanced Cancer: a Mixed-Methods Systematic Review.

Sarah Davis, Marc Serfaty, Joe Low, Megan Armstrong, Nuriye Kupeli, Anne Lanceley

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of behavioral medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sarah DavisDivision of Psychiatry, Marie Curie Palliative Care Research Dept, University College London, Maple House, Tottenham Court Road, London, W1T 7NF, UK. s.davis@ucl.ac.uk.ORCID http://orcid.org/0000-0002-1933-716X
Marc SerfatyDivision of Psychiatry, University College London, London, UK.
Joe LowDivision of Psychiatry, Marie Curie Palliative Care Research Dept, University College London, Maple House, Tottenham Court Road, London, W1T 7NF, UK.
Megan ArmstrongPrimary Care and Population Health, University College London, London, UK.
Nuriye KupeliDivision of Psychiatry, Marie Curie Palliative Care Research Dept, University College London, Maple House, Tottenham Court Road, London, W1T 7NF, UK.
Anne LanceleyEGA Institute for Women's Health, Department of Women's Cancer, University College London, London, UK.

Funding

Marie Curie MCCC-FCO-11-U
6 · The paper itself

Abstract

backgroundPeople with advanced cancer experience psychological distress due to physical symptoms, functional decline, and a limited prognosis. Difficult thoughts, feelings, and emotions may exacerbate distress and lead to avoidance of these experiences which is sometimes referred to as experiential avoidance (EA). Advanced cancer patients may be more likely to engage in EA especially when no obvious solutions to their problems exist. This study aims to examine the terms used to describe EA, the processes that might indicate EA, associations between EA and psychological distress, and to understand why individuals might engage in EA.

methodsA mixed-methods review. Literature search of Medline, Embase, Psych INFO, and CINAHL 1980-October 2019. INCLUSION: adults ≥ 18 years; advanced cancer not amenable to cure. EXCLUSION: no measures of EA or psychological distress. Risk of bias and study quality assessed. Evidence of statistical techniques collected. Themes coded, grouped, and developed based on meaning.

resultsNineteen studies identified, 13 quantitative studies and 6 qualitative. The quantitative of which 6 compared early-stage cancers with advanced cancers and examined subscales of EA alongside mood, quality of life, and psychological distress. EA covers a range or terms of which 'avoidant coping' is the commonest. EA is manifest as cognitive, behavioural, and emotional avoidance. A thematic synthesis suggests the function of EA is to protect people from distress, and from confronting or expressing difficult emotions by avoiding communication about cancer, controlling negative information, and maintaining normality and hope and optimism.

conclusionsEA may be beneficial in the short term to alleviate distress, but in the longer term, it can impair function and limit engagement in life. Greater clinical awareness of the complexity of EA behaviours is needed. Clinicians and researchers should define EA precisely and be aware of the function it may serve in the short and longer term. Future research studies may consider using specific measures of EA as a primary outcome, to assess the impact of psychological interventions such as ACT.

Indexed as

NeoplasmsStress, PsychologicalAdultAffectEmotionsHumansQuality of LifeAdvanced cancerExperiential avoidanceMixed methodsPsycho-oncologySystematic review

Identifiers

PMID36284042
PMCPMC10522753

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.