Aim: To examine effectiveness of professionally-led support groups for people with advanced cancer and identify factors critical to implementation success within real-world healthcare settings.
Method: Databases (MEDLINE; PsychINFO; CINAHL) and the grey literature were searched for empirical publications and evaluations. Articles were double-screened for eligibility and data systematically extracted, charted and summarised using a modified Arksey and O’Malley scoping review methodology.1 Implementation factors were mapped against Proctor’s implementation framework.2 Factors impacting on implementation success (e.g. adoption, uptake) were identified through mapping to the Consolidated Framework for Implementation Research.3
Results: 1690 publications were identified. 22 studies were eligible for inclusion (10 RCTs, 6 evaluations, 5 observational/exploratory studies, 1 case study). Most studies reported on cancer-specific support groups (breast, n=16, 73%; ovarian n=1, 5%; prostate, n=1; 5%; brain, n=1; 5%) rather than mixed cancer groups (n=3; 14%). Majority (n=20; 91%) were patient only; one (5%) was for family members and one (5%) for caregivers and family members. Most were delivered face-to-face (n=19; 86%); one (5%) was online; and one (5%) had a hybrid format (simultaneous face-to-face/teleconference). Most (n=18; 82%) were weekly. Most were informed by a psycho-theoretical framework, typically supportive-expressive group therapy. Key outcomes included: psychosocial or affective mood (e.g. mood disturbance, traumatic stress) (n=6; 27%); quality-of-life (n=2; 9%); pain symptoms (n=2; 9%); and survival (n=6; 27%). Initial reports of survival benefit were not replicated. Several studies demonstrated short- and medium-term psychosocial benefits. Further benefits included connection, knowledge sharing, normalisation of death/dying, acceptance and meaning-making. Frequently reported implementation outcomes included: acceptability, feasibility and fidelity; few reported sustainability. Key determinants of successful implementation included facilitators’ skills/experience, having more than one facilitator, mode of operation (i.e. face-to-face or teleconference) and resourcing.
Conclusion: Professionally-run support groups for people with advanced cancer improve psychosocial outcomes and quality-of-life. Participants and facilitators reported high levels of acceptability.