J Korean Acad Nurs.  2017 Apr;47(2):143-163. 10.4040/jkan.2017.47.2.143.

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

Affiliations
  • 1College of Nursing · Nursing Research Institute, Ajou University, Suwon, Korea. shyoung@ajou.ac.kr

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.

Keyword

Neoplasms; Survivors; Education; Behavior therapy; Meta-analysis

MeSH Terms

Adaptation, Physiological
Anxiety
Cancer Survivors/*psychology
Databases, Factual
Depression/pathology
Humans
Quality of Life
Self Efficacy

Figure

  • Figure 1 Flow diagram of study screening.

  • Figure 2 Forest plots of the effect of psychoeducational intervention.

  • Figure 3 Effect sizes of psychoeducational intervention by types of intervention.

  • Figure 4 Funnel plots of standard error by standardized mean difference.


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