Communication, information and support for adults with malignant cerebral glioma : a systematic literature review

The goal of this work was a systematic review of communication, information and support for adults with malignant cerebral glioma. Medical, nursing and social science computerised databases up to spring 2000 were searched. Key organisations were contacted, and specialist journals were searched. Inclusion criteria were publication in English, inclusion of patients with malignant cerebral glioma, measurement of patients' and relatives' awareness of the prognosis, distress, satisfaction with information or care received, uptake of service or professional communication skills. Studies of patients with other cancers were excluded. Qualitative and quantitative studies were assessed, graded for methodological quality and combined. Twelve observational studies were found, although many were limited by sample selection, description and setting. Patient awareness of the prognosis varied, and relatives appeared more aware. There was no direct evidence about what patients and relatives wanted to know, but qualitative studies suggested that an individual approach to disclosure and maintaining hope were important. Most patients and relatives valued specialist nurse support highly. No specific studies of interventions to break bad news, giving information or training staff were found for these patients. Evidence from observational studies suggests that these patients need individually tailored communication and information, and specialist support. Existing intervention studies of patients with other cancers may suggest effective strategies.