The effects of psychoeducational care provided to adults with cancer: meta-analysis of 116 studies

Abstract

Purpose/objectives: To determine how educational and psychosocial care provided to adults with cancer affects seven outcomes--anxiety, depression, mood, nausea, vomiting, pain, and knowledge.

Design: Meta-analysis.

Sample: 116 intervention studies. A standardized mean difference between a treatment and control group (i.e., an effect-size value) was calculated for 98 studies; for 18 additional studies, it was only possible to code the direction of treatment effect (i.e., whether the treatment or control group had a higher score). Most analyses were limited to the 98 studies from which an effect-size value was obtainable. These studies were published between 1976 and 1993 and were based on data obtained from 5,326 patients with cancer.

Methods: A comprehensive literature search yielded more than 20,000 potentially relevant citations that were reviewed. Study, subject, treatment, and outcome characteristics of the studies meeting selection criteria were coded.

Main research variables: Manner of subject assignment to treatment condition; type of control group; publication form; type of psychoeducational care; and the outcomes of anxiety, depression, mood, nausea, vomiting, pain, and knowledge.

Findings: Statistically significant, beneficial effects were found in relation to all seven of the outcomes. Three threats to validity were examined and were not found to be a problem related to the outcomes examined.

Conclusions: Psychoeducational care was found to benefit adults with cancer in relation to anxiety, depression, mood, nausea, vomiting, pain, and knowledge. Differentiating among the effectiveness of various types of psychoeducational care was problematic. To maximize the utility of this knowledge for clinicians, more research is needed to evaluate the relative effectiveness of different types of psychoeducational care.

Implications for nursing practice: A strong research base has established the beneficial effects of psychoeducational care. Clinicians should examine their practice to determine if research-based psychoeducational care is being used sufficiently.