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

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.