A biopsychosocial perspective on adjustment and quality of life following brain tumor: A systematic evaluation of the literature

PURPOSE: To systematically evaluate the literature on quality of life and adjustment to brain tumor from a biopsychosocial perspective. METHODS: On the basis of the cancer and brain injury literature, a biopsychosocial organisational framework was initially developed to support an evaluative review of the brain tumor literature. This framework consisted of four themes relating to pre-illness characteristics, neuropathology, personal appraisals and reactions and social support. Electronic searches of Medline, PsycINFO and CINAHL databases identified 48 empirical studies (1980-2007) that investigated factors associated with quality of life or the adjustment of adults with brain tumor. A review of studies within each theme appraised these findings and evaluated the quality of methodology and extent to which biopsychosocial perspectives have guided investigations. RESULTS: Overall, the review identified consistent associations between depression, performance status, fatigue and quality of life. Seven multivariate studies with strong methodology that adopted a biopsychosocial perspective were found. In general, the relationships among pre-illness and brain tumor characteristics, psychosocial variables and quality of life were unclear and various gaps in the literature emerged. CONCLUSIONS: Empirical findings within a biopsychosocial perspective may guide the development and delivery of support services for individuals with brain tumor; however, many important areas exist for future research.