DOI QR코드

DOI QR Code

Effects of Psychoeducational Intervention for Cancer Survivors: A Systematic Review and Meta-Analysis

암생존자를 위한 심리교육중재의 효과에 대한 체계적 고찰 및 메타분석

  • Park, Jin-Hee (College of Nursing.Nursing Research Institute, Ajou University) ;
  • Bae, Sun Hyoung (College of Nursing.Nursing Research Institute, Ajou University)
  • 박진희 (아주대학교 간호대학.간호과학연구소) ;
  • 배선형 (아주대학교 간호대학.간호과학연구소)
  • Received : 2016.12.23
  • Accepted : 2017.03.02
  • Published : 2017.04.30

Abstract

Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

Keywords

References

  1. Ashing KT, Miller AM. Assessing the utility of a telephonically delivered psychoeducational intervention to improve healthrelated quality of life in African American breast cancer survivors: A pilot trial. Psycho-Oncology. 2016;25(2):236-238. http://dx.doi.org/10.1002/pon.3823
  2. Ashing-Giwa KT. Enhancing physical well-being and overall quality of life among underserved Latina-American cervical cancer survivors: Feasibility study. Journal of Cancer Survivorship. 2008;2(3):215-223. http://dx.doi.org/10.1007/s11764-008-0061-2
  3. Bjorneklett HG, Lindemalm C, Ojutkangas ML, Berglund A, Letocha H, Strang P, et al. A randomized controlled trial of a support group intervention on the quality of life and fatigue in women after primary treatment for early breast cancer. Supportive Care in Cancer. 2012;20(12):3325-3334. http://dx.doi.org/10.1007/s00520-012-1480-1
  4. Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, et al. Mindfulness meditation for younger breast cancer survivors: A randomized controlled trial. Cancer. 2015;121(8):1231-1240. http://dx.doi.org/10.1002/cncr.29194
  5. Branstrom R, Kvillemo P, Moskowitz JT. A randomized study of the effects of mindfulness training on psychological wellbeing and symptoms of stress in patients treated for cancer at 6-month follow-up. International Journal of Behavioral Medicine. 2012;19(4):535-542. http://dx.doi.org/10.1007/s12529-011-9192-3
  6. Classen CC, Kraemer HC, Blasey C, Giese-Davis J, Koopman C, Palesh OG, et al. Supportive-expressive group therapy for primary breast cancer patients: A randomized prospective multicenter trial. Psycho-Oncology. 2008;17(5):438-447. http://dx.doi.org/10.1002/pon.1280
  7. Crane-Okada R, Kiger H, Sugerman F, Uman GC, Shapiro SL, Wyman-McGinty W, et al. Mindful movement program for older breast cancer survivors: A pilot study. Cancer Nursing. 2012;35(4):E1-E13. http://dx.doi.org/10.1097/NCC.0b013e3182280f73
  8. Dolbeault S, Cayrou S, Bredart A, Viala AL, Desclaux B, Saltel P, et al. The effectiveness of a psycho-educational group after early-stage breast cancer treatment: Results of a randomized French study. Psycho-Oncology. 2009;18(6):647-656. http://dx.doi.org/10.1002/pon.1440
  9. Germino BB, Mishel MH, Crandell J, Porter L, Blyler D, Jenerette C, et al. Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors. Oncology Nursing Forum. 2013;40(1):82-92. http://dx.doi.org/10.1188/13.onf.82-92
  10. Hershman DL, Greenlee H, Awad D, Kalinsky K, Maurer M, Kranwinkel G, et al. Randomized controlled trial of a clinicbased survivorship intervention following adjuvant therapy in breast cancer survivors. Breast Cancer Research and Treatment. 2013;138(3):795-806. http://dx.doi.org/10.1007/s10549-013-2486-1
  11. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: A randomized, controlled trial. Journal of Clinical Oncology. 2012;30(12):1335-1342. http://dx.doi.org/10.1200/jco.2010.34.0331
  12. Jang S. Effects of meditation program on power, anxiety, depression and quality of life in women with breast cancer. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2013;22(3):205-215. http://dx.doi.org/10.12934/jkpmhn.2013.22.3.205
  13. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: Evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). Journal of Behavioral Medicine. 2014;37(2):185-195. http://dx.doi.org/10.1007/s10865-012-9473-6
  14. Lepore SJ, Helgeson VS. Psychoeducational support group enhances quality of life after prostate cancer. Cancer Research Therapy and Control. 1999;8:81-91.
  15. Lerman R, Jarski R, Rea H, Gellish R, Vicini F. Improving symptoms and quality of life of female cancer survivors: A randomized controlled study. Annals of Surgical Oncology. 2012;19(2):373-378. http://dx.doi.org/10.1245/s10434-011-2051-2
  16. Loprinzi CE, Prasad K, Schroeder DR, Sood A. Stress management and resilience training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: A pilot randomized clinical trial. Clinical Breast Cancer. 2011;11(6):364-368. http://dx.doi.org/10.1016/j.clbc.2011.06.008
  17. Marcus AC, Garrett KM, Cella D, Wenzel L, Brady MJ, Fairclough D, et al. Can telephone counseling post-treatment improve psychosocial outcomes among early stage breast cancer survivors? Psycho-Oncology. 2010;19(9):923-932. http://dx.doi.org/10.1002/pon.1653
  18. May AM, Korstjens I, van Weert E, van den Borne B, Hoekstra-Weebers JE, van der Schans CP, et al. Long-term effects on cancer survivors' quality of life of physical training versus physical training combined with cognitive-behavioral therapy: Results from a randomized trial. Supportive Care in Cancer. 2009;17(6):653-663. http://dx.doi.org/10.1007/s00520-008-0519-9
  19. Meneses K, McNees P, Azuero A, Loerzel VW, Su X, Hassey LA. Preliminary evaluation of psychoeducational support interventions on quality of life in rural breast cancer survivors after primary treatment. Cancer Nursing. 2009;32(5):385-397. http://dx.doi.org/10.1097/NCC.0b013e3181a850e6
  20. Meneses KD, McNees P, Loerzel VW, Su X, Zhang Y, Hassey LA. Transition from treatment to survivorship: Effects of a psychoeducational intervention on quality of life in breast cancer survivors. Oncology Nursing Forum. 2007;34(5):1007-1016. http://dx.doi.org/10.1188/07.onf.1007-1016
  21. Mishel MH, Germino BB, Gil KM, Belyea M, Laney IC, Stewart J, et al. Benefits from an uncertainty management intervention for African-American and Caucasian older long-term breast cancer survivors. Psycho-Oncology. 2005;14(11):962-978. http://dx.doi.org/10.1002/pon.909
  22. Miyashita M. A randomized intervention study for breast cancer survivors in Japan: Effects of short-term support group focused on possible breast cancer recurrence. Cancer Nursing. 2005;28(1):70-78. http://dx.doi.org/10.1097/00002820-200501000-00011
  23. Napoles AM, Ortiz C, Santoyo-Olsson J, Stewart AL, Gregorich S, Lee HE, et al. Nuevo Amanecer: Results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer. American Journal of Public Health. 2015;105(Suppl 3):e55-e63. http://dx.doi.org/10.2105/ajph.2015.302598
  24. Nelson EL, Wenzel LB, Osann K, Dogan-Ates A, Chantana N, Reina-Patton A, et al. Stress, immunity, and cervical cancer: Biobehavioral outcomes of a randomized clinical trial [corrected]. Clinical Cancer Research. 2008;14(7):2111-2118. http://dx.doi.org/10.1158/1078-0432.ccr-07-1632
  25. Osei DK, Lee JW, Modest NN, Pothier PK. Effects of an online support group for prostate cancer survivors: A randomized trial. Urologic Nursing. 2013;33(3):123-133. http://dx.doi.org/10.7257/1053-816X.2013.33.3.123
  26. Park JH, Bae SH, Jung YS, Kim KS. Quality of life and symptom experience in breast cancer survivors after participating in a psychoeducational support program: A pilot study. Cancer Nursing. 2012;35(1):E34-E41. http://dx.doi.org/10.1097/NCC.0b013e318218266a
  27. Park K, Jun JS, Jung SY. The effects of Korean mindfulness based stress reduction program on the psychological symptoms, sleep and quality of life, in Korea breast cancer patients. Korean Journal of Stress Research. 2013;21(3):249-262.
  28. Penedo FJ, Dahn JR, Molton I, Gonzalez JS, Kinsinger D, Roos BA, et al. Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinoma. Cancer. 2004;100(1):192-200. http://dx.doi.org/10.1002/cncr.11894
  29. Rottmann N, Dalton SO, Bidstrup PE, Wurtzen H, Hoybye MT, Ross L, et al. No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial. Psycho-Oncology. 2012;21(5):505-514. http://dx.doi.org/10.1002/pon.1924
  30. Siddons HM, Wootten AC, Costello AJ. A randomised, waitlist controlled trial: Evaluation of a cognitive-behavioural group intervention on psycho-sexual adjustment for men with localised prostate cancer. Psycho-Oncology. 2013;22(10):2186-2192. http://dx.doi.org/10.1002/pon.3273
  31. Simpson JS, Carlson LE, Beck CA, Patten S. Effects of a brief intervention on social support and psychiatric morbidity in breast cancer patients. Psycho-Oncology. 2002;11(4):282-294. http://dx.doi.org/10.1002/pon.565
  32. Traeger L, Penedo FJ, Benedict C, Dahn JR, Lechner SC, Schneiderman N, et al. Identifying how and for whom cognitive-behavioral stress management improves emotional wellbeing among recent prostate cancer survivors. Psycho-Oncology. 2013;22(2):250-259. http://dx.doi.org/10.1002/pon.2074
  33. Willems RA, Bolman CA, Mesters I, Kanera IM, Beaulen AA, Lechner L. Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: Randomized controlled trial. Psycho-Oncology. 2017;26(2):222-230. http://dx.doi.org/10.1002/pon.4113
  34. Yun YH, Lee MK, Bae Y, Shon EJ, Shin BR, Ko H, et al. Efficacy of a training program for long-term disease- free cancer survivors as health partners: A randomized controlled trial in Korea. Asian Pacific Journal of Cancer Prevention. 2013;14(12):7229-7235. http://dx.doi.org/10.7314/apjcp.2013.14.12.7229
  35. Zhang H, Zhou Y, Cui Y, Yang J. The effectiveness of a rehabilitation programme for Chinese cancer survivors: A pilot study. International Journal of Nursing Practice. 2016;22(1):79-88. http://dx.doi.org/10.1111/ijn.12370

Cited by

  1. Effects of Elastic Band Resistance Training on Muscle Strength among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis vol.23, pp.3, 2018, https://doi.org/10.9708/jksci.2018.23.03.071
  2. Chemotherapy Education and Support: A Model for Use in the Ambulatory Care Setting vol.24, pp.4, 2020, https://doi.org/10.1188/20.cjon.e43-e49
  3. Development of A Nurse-Led Educational Intervention Program in Managing the Nutrition Impact Symptom Cluster in Patients with Nasopharyngeal Carcinoma following the Medical Research Council Framework vol.8, pp.6, 2017, https://doi.org/10.4103/apjon.apjon-2141
  4. Effects of Psychosocial Interventions on Physical Function and Depression in Stroke Patients: Systematic Review and Meta-analysis vol.33, pp.2, 2017, https://doi.org/10.13000/jfmse.2021.4.33.2.396
  5. Effects of Nurse-Led Intervention Programs Based on Goal Attainment Theory: A Systematic Review and Meta-Analysis vol.9, pp.6, 2017, https://doi.org/10.3390/healthcare9060699