Psychological interventions for anxiety in older patients with lung cancer: A systematic review.

Abstract

e24046 Background: Lung cancer is the leading cause of death among cancer types and primarily occurs among older adults. Anxiety in older adults tends to be undertreated and underdiagnosed, due to the overlap in symptoms with comorbidities, depression, side effects from medications, and their lower tendency to seek mental health services. Older adults with lung cancer experience higher levels of anxiety in comparison to patients with other cancers. Therefore, this systematic review aims to summarize the literature on psychological interventions in older adults with lung cancer. Methods: Using PRIMA guidelines, PsycNet (Medline/PsycInfo), Embase, PubMed, and Web of Science were searched with key terms, resulting in 2443 initial studies, 16 of which met inclusion criteria. Results: The studied psychological interventions for this population included: cognitive-behavioral approach therapies, mindfulness-based interventions (such as MBSR), self-efficacy and psychosocial interventions, acceptance and commitment therapy (ACT), coping skills training (CST), psychoeducation, dignity therapy, reminiscence therapy, and positive psychology interventions. Among the interventions studied across 16 articles, mindfulness-based interventions and self-efficacy interventions consistently showed significant reductions in anxiety symptoms across studies. ACT and psychoeducation did not demonstrate evidence of reduction of anxiety. Other studies showed some potential in reducing the psychological burden in this population. Few studies focused on an older adult population, and only two interventions were designed specifically for older adults. Conclusions: Psychological studies that incorporate geriatric principles are essential for improving anxiety for older adults with lung cancer. More rigorous randomized clinical trials are needed to assess the long-term effects of these interventions on psychological distress and anxiety in older adults with lung cancer.