The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: A systematic review and meta-analysis

Hannah Matthews, Elizabeth A. Grunfeld, Andrew Turner

Research output: Contribution to journalArticle

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Abstract

Objective: Breast cancer is the most commonly diagnosed cancer in women across the world. The majority of women diagnosed with the disease undergo surgery, which is often associated with significant psychosocial morbidity. The aim of this meta-analysis was to identify the efficacy of psychosocial interventions for women following breast cancer surgery.Method: A comprehensive literature search was undertaken using keyword and subject headings within 7 databases. Included studies employed a quantitative methodology presenting empirical findings focusing on interventions for female breast cancer patients following surgery.Results: Thirty-two studies were included and based on conventional values of effect sizes. Small effects emerged for the efficacy of psychosocial interventions in relation to anxiety (Hedges g = 0.31), depression (0.38), quality of life (0.40), mood disturbance (0.31), distress (0.27), body image (0.40), self-esteem (0.35), and sexual functioning (0.22). A moderate to large effect emerged for the efficacy of interventions in promoting improvements in sleep disturbance (0.67). Clear evidence emerged for the efficacy of cognitive behavioral therapy in promoting improvements in anxiety, depression, and quality of life.Conclusion: This is the first meta-analysis to demonstrate the efficacy of interventions on a range of psychosocial outcomes following breast cancer surgery. The meta-analysis highlighted that cognitive behavioral therapy was consistently the most effective psychosocial intervention promoting improvements in anxiety, depression, and quality of life. However, there are shortcomings in existing studies; the length of the follow-up period is typically short and the generalizability of findings was limited by small samples, both of which should be addressed in future studies. Publisher Statement: This is the peer reviewed version of the following article: Matthews, H, Grunfeld, EA & Turner, A 2016, 'The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: A systematic review and meta-analysis' Psycho-oncology, vol 26, no. 5, pp. 593-607, which has been published in final form at https://dx.doi.org/10.1002/pon.4199. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Original languageEnglish
Pages (from-to)593-607
Number of pages15
JournalPsycho-Oncology
Volume26
Issue number5
Early online date22 Jun 2016
DOIs
Publication statusPublished - 2 Aug 2016

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Meta-Analysis
Breast Neoplasms
Anxiety
Quality of Life
Cognitive Therapy
Depression
Therapeutics
Body Image
Self Concept
Sleep
Databases
Morbidity
Neoplasms

Keywords

  • cancer
  • mastectomy
  • meta‐analysis
  • oncology
  • psychosocial interventions

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The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer : A systematic review and meta-analysis. / Matthews, Hannah; Grunfeld, Elizabeth A.; Turner, Andrew.

In: Psycho-Oncology, Vol. 26, No. 5, 02.08.2016, p. 593-607.

Research output: Contribution to journalArticle

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AB - Objective: Breast cancer is the most commonly diagnosed cancer in women across the world. The majority of women diagnosed with the disease undergo surgery, which is often associated with significant psychosocial morbidity. The aim of this meta-analysis was to identify the efficacy of psychosocial interventions for women following breast cancer surgery.Method: A comprehensive literature search was undertaken using keyword and subject headings within 7 databases. Included studies employed a quantitative methodology presenting empirical findings focusing on interventions for female breast cancer patients following surgery.Results: Thirty-two studies were included and based on conventional values of effect sizes. Small effects emerged for the efficacy of psychosocial interventions in relation to anxiety (Hedges g = 0.31), depression (0.38), quality of life (0.40), mood disturbance (0.31), distress (0.27), body image (0.40), self-esteem (0.35), and sexual functioning (0.22). A moderate to large effect emerged for the efficacy of interventions in promoting improvements in sleep disturbance (0.67). Clear evidence emerged for the efficacy of cognitive behavioral therapy in promoting improvements in anxiety, depression, and quality of life.Conclusion: This is the first meta-analysis to demonstrate the efficacy of interventions on a range of psychosocial outcomes following breast cancer surgery. The meta-analysis highlighted that cognitive behavioral therapy was consistently the most effective psychosocial intervention promoting improvements in anxiety, depression, and quality of life. However, there are shortcomings in existing studies; the length of the follow-up period is typically short and the generalizability of findings was limited by small samples, both of which should be addressed in future studies. Publisher Statement: This is the peer reviewed version of the following article: Matthews, H, Grunfeld, EA & Turner, A 2016, 'The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: A systematic review and meta-analysis' Psycho-oncology, vol 26, no. 5, pp. 593-607, which has been published in final form at https://dx.doi.org/10.1002/pon.4199. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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