Skip to main content

Advertisement

SpringerLink
Log in

Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Psychoeducation interventions have been suggested to improve sexual functioning and quality of life. The aim of this study was to examine the effects of the psychoeducation intervention on quality of life, sexual function, and psychological outcomes; and to identify the critical components of psychoeducation intervention for women with gynecological cancer. This study was a systematic review and meta-analysis. Psychoeducation interventions were searched using six English databases, eligible studies were extracted, and the risk of bias was evaluated by two authors independently. A random effects model was used to examine the intervention effects. We conducted subgroup analysis and meta-regression to assess the variables underlying the heterogeneity. In total, eight trials were identified, and 1128 participants were included. Women who received the psychoeducation intervention had better quality of life (standardized mean difference (SMD) = 0.59, 95% confidence interval (CI): 0.22, 0.97), sexual functioning (SMD = 0.63, 95% CI: 0.27, 0.99), and psychological outcomes (i.e., anxiety and depression (SMD =  − 0.27, 95% CI: − 0.09, − 0.44)). Interventions that combined lecture-based, skill practical, discussion, and counseling were conducted using an online format and were delivered by a team of health professionals that had higher scores of qualities of life. Additionally, involving significant others in the intervention improved sexual functioning. Psychoeducation interventions effectively improve quality of life, sexual functioning, anxiety, and depression. Incorporating lecture-based, practical skills, discussion, and counseling through an online format and involving significant others are beneficial for improving the quality of life and sexual functioning among women with gynecological cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Not applicable.

Code availability

Not applicable.

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492

    Article  Google Scholar 

  2. Carneiro SR, Fagundes MdA, do Rosário PdJO, Neves LMT, Souza GdS, Pinheiro MdCN (2017) Five-year survival and associated factors in women treated for cervical cancer at a reference hospital in the Brazilian Amazon. PLoS ONE 12(11):e0187579. https://doi.org/10.1371/journal.pone.0187579

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mantia-Smaldone GM, Edwards RP, Vlad AM (2011) Targeted treatment of recurrent platinum-resistant ovarian cancer: current and emerging therapies. Cancer Manag Res 3:25

    CAS  PubMed  Google Scholar 

  4. Aerts L, Enzlin P, Vergote I, Verhaeghe J, Poppe W, Amant F (2012) Sexual, psychological, and relational functioning in women after surgical treatment for vulvar malignancy: a literature review. J Sex Med 9(2):361–371. https://doi.org/10.1111/j.1743-6109.2011.02520.x

    Article  PubMed  Google Scholar 

  5. Chow KM, Chan JCY, Choi KC, Chan WHC (2016) A review of psychoeducational interventions to improve sexual functioning, quality of life, and psychological outcomes in gynecological cancer patients. Cancer Nurs 39(1):20–31. https://doi.org/10.1097/NCC.0000000000000234

    Article  PubMed  Google Scholar 

  6. McCorkle R, Dowd M, Ercolano E, Schulman-Green D, Williams A (2009) Effects of a nursing intervention on quality of life outcomes in post-surgical women with gynecological cancers. Psychooncology 23(18):62–70. https://doi.org/10.1002/pon.1365

    Article  Google Scholar 

  7. Nelson et al (2008) Stress, immunity, and cervical cancer: biobehavioral outcomes of a randomized clinical trial. Physiol Behav 14(7):2111–2118. https://doi.org/10.1158/1078-0432.CCR-07-1632

    Article  Google Scholar 

  8. Deaton A, Cartwright N (2018) Understanding and misunderstanding randomized controlled trials. Soc Sci Med 210(1997):2–21. https://doi.org/10.1016/j.socscimed.2017.12.005

    Article  PubMed  Google Scholar 

  9. Ganeshkumar P, Gopalakrishnan S (2013) Systematic reviews and meta-analysis: understanding the best evidence in primary healthcare. J Family Med Prim Care 2(1):9. https://doi.org/10.4103/2249-4863.109934

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nguyen LT, Alexander K, Yates P (2018) Psychoeducational intervention for symptom management of fatigue, pain, and sleep disturbance cluster among cancer patients: a pilot quasi-experimental study. J Pain Symptom Manage 55(6):1459–1472. https://doi.org/10.1016/j.jpainsymman.2018.02.019

    Article  PubMed  Google Scholar 

  11. Schofield P, Gough K, Pascoe M et al (2020) A nurse- and peer-led psychoeducational intervention to support women with gynecological cancers receiving curative radiotherapy: the PeNTAGOn randomised controlled trial – ANZGOG 1102. Gynecol Oncol 159(3):785–793. https://doi.org/10.1016/j.ygyno.2020.09.016

    Article  CAS  PubMed  Google Scholar 

  12. Classen CC, Chivers ML, Urowitz S, Barbera L, Wiljer D, O’Rinn S, Ferguson SE (2012) Psychosexual distress in women with gynecologic cancer: a feasibility study of an online support group. Psychooncology 22(4):930–935. https://doi.org/10.1002/pon.3058

    Article  PubMed  Google Scholar 

  13. Page MJ, McKenzie JE, Bossuyt PM, et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ, 372. https://doi.org/10.1136/bmj.n71

  14. World Health Organization (2004) World Health Organization Quality of Life (WHOQOL). The World Health Organization Quality of Life (WHOQOL)-BREF. https://doi.org/10.4324/9781003076391-184

  15. Ilić I, Šipetić S, Grujičić J, Mačužić IŽ, Kocić S, Ilić M (2019) Psychometric properties of the world health organization’s quality of life (WHOQOL-BREF) questionnaire in medical students. Medicine (Lithuania) 55:12. https://doi.org/10.3390/medicina55120772

    Article  Google Scholar 

  16. Shi Y, Cai J, Wu Z, Jiang L, Xiong G, Guan X, Wang X (2020) Effects of a nurse-led positive psychology intervention on sexual function, depression, and subjective wellbeing in postoperative patients with early-stage cervical cancer: a randomized controlled trial. Int J Nurs Stud 111(74):103768. https://doi.org/10.1016/j.ijnurstu.2020.103768

    Article  PubMed  Google Scholar 

  17. Shirali E, Yarandi F, Ghaemi M, Montazeri A (2020) Quality of life in patients with gynecological cancers a web based study. Asian Pac J Cancer Prev 21(7):1969–1975. https://doi.org/10.31557/APJCP.2020.21.7.1969

    Article  PubMed  PubMed Central  Google Scholar 

  18. Maina GM, Mauri AR (2016) Anxiety and depression. The Oxford Handbook of Mood Disorders, 236–250. https://doi.org/10.1093/oxfordhb/9780199973965.013.27

  19. Nicolaisen A, Hagedoorn M, Hansen DG, Flyger HL, Christensen R, Rottmann N, Lunn PB, Terp H, Soee K, Johansen C (2018) The effect of an attachment-oriented couple intervention for breast cancer patients and partners in the early treatment phase: a randomised controlled trial. Psychooncology 27(3):922–928. https://doi.org/10.1002/pon.4613

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JAC (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Online) 343(7829):1–9. https://doi.org/10.1136/bmj.d5928

    Article  Google Scholar 

  21. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias author(s). Biometrics 50(4): 1088–1101. http://www.jstor.org/stable/2533446.

  22. Chow KM, Chan CWH, Choi KC, Siu KY, Fung HKS, Sum WM (2019) A theory-driven psychoeducational intervention programme for gynecological cancer patients during treatment trajectory: a randomised controlled trial. Psychooncology 29(2):437–443. https://doi.org/10.1002/pon.5284

    Article  PubMed  Google Scholar 

  23. Chow KM, Chan CWH, Choi KC, Siu KY (2014) A feasibility study of a psychoeducational intervention program for gynecological cancer patients. Eur J Oncol Nurs 18(4):385–392. https://doi.org/10.1016/j.ejon.2014.03.011

    Article  PubMed  Google Scholar 

  24. Li J, Huang J, Zhang J, Li Y (2016) A home-based, nurse-led health program for postoperative patients with early-stage cervical cancer: a randomized controlled trial. Eur J Oncol Nurs 21:174–180. https://doi.org/10.1016/j.ejon.2015.09.009

    Article  PubMed  Google Scholar 

  25. Schover LR (2013) Efficacy trial of an internet-based intervention for cancer-related female sexual dysfunction. Int J Urol Nurs 8(1):38–43. https://doi.org/10.1111/ijun.2014.8.issue-1

    Article  Google Scholar 

  26. Kim J, Yang Y, Hwang E (2015) The effectiveness of psychoeducational interventions focused on sexuality. Cancer Nurs 38:5. https://doi.org/10.1097/NCC.0000000000000212

    Article  Google Scholar 

  27. Lin H, Ye M, Chan SW, Zhu J, He H (2020) The effectiveness of online interventions for patients with gynecological cancer: an integrative review. Gynecol Oncol 158(1):143–152. https://doi.org/10.1016/j.ygyno.2020.04.690

    Article  PubMed  Google Scholar 

  28. McCorkle R, Ercolano E, Lazenby M, Schulman-Green D, Schilling LS, Lorig K, Wagner EH (2011) Self-management: enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin 61(1):50–62. https://doi.org/10.3322/caac.20093

    Article  PubMed  PubMed Central  Google Scholar 

  29. Afiyanti Y, Wardani IY, Martha E (2019) The quality of life of women with cervical cancer in Indonesia: a cross-sectional study. Nurse Media J Nurs 9(2):128–140. https://doi.org/10.14710/nmjn.v9i2.26014

    Article  Google Scholar 

  30. Bober SL, Recklitis CJ, Bakan J, Garber JE, Patenaude AF (2015) Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention. J Sex Med 12(1):189–197. https://doi.org/10.1111/jsm.12713

    Article  PubMed  Google Scholar 

  31. Fabian A, Krug D, Alkatout I (2020) Radiotherapy and its intersections with surgery in the management of localized gynecological malignancies: a comprehensive overview for clinicians. J Clin Med 10(1):93. https://doi.org/10.3390/jcm10010093

    Article  PubMed Central  Google Scholar 

  32. Weare K (2015) Rehabilitation after gynecological cancer treatment. Int J Gynaecol Obstet 131(December):S164–S166. https://doi.org/10.1016/j.ijgo.2015.06.015

    Article  PubMed  Google Scholar 

  33. Lubotzky F, Butow P, Nattress K, Hunt C, Carroll S, Comensoli A, Philp S, Juraskova I (2016) Facilitating psychosexual adjustment for women undergoing pelvic radiotherapy: pilot of a novel patient psychoeducational resource. Health Expect 19(6):1290–1301. https://doi.org/10.1111/hex.12424

    Article  PubMed  Google Scholar 

  34. Sopfe J, Pettigrew J, Afghahi A, Appiah LC, Coons HL (2021) Interventions to improve sexual health in women living with and surviving cancer: review and recommendations. Cancers 13(13):1–25. https://doi.org/10.3390/cancers13133153

    Article  Google Scholar 

  35. Rodrigues F, Bartolo A, Pacheco E, Pereira A, Silva CF, Oliveira C (2018) Psychoeducation for anxiety disorders in adults: a systematic review of its effectiveness. J Forensic Psychol 03(02):1–5. https://doi.org/10.4172/2475-319x.1000142

    Article  Google Scholar 

  36. Darling-Hammond L, Flook L, Cook-Harvey C, Barron B, Osher D (2020) Implications for educational practice of the science of learning and development. Appl Dev Sci 24(2):97–140. https://doi.org/10.1080/10888691.2018.1537791

    Article  Google Scholar 

  37. Bober SL, Recklitis CJ, Michaud AL, Wright AA (2018) Improvement in sexual function after ovarian cancer: effects of sexual therapy and rehabilitation after treatment for ovarian cancer. Cancer 124(1):176–182. https://doi.org/10.1002/cncr.30976

    Article  PubMed  Google Scholar 

  38. Bakker RM et al (2017) A nurse-led sexual rehabilitation intervention after radiotherapy for gynecological cancer. Support Care Cancer 25(3):729–737. https://doi.org/10.1007/s00520-016-3453-2

    Article  CAS  PubMed  Google Scholar 

  39. Rezayat F, Dehghan Nayeri N (2013) Self-efficacy afterlife skills training: a case-control study. Nurs Midwifery Stud 2(2):83–88. https://doi.org/10.5812/nms.11691

    Article  PubMed  PubMed Central  Google Scholar 

  40. Khanshan SK, Yousefi MH (2020) The relationship between self-efficacy and instructional practice of in-service soft disciplines, hard disciplines, and EFL teachers. Asian Pac J Sec Foreign Lang Educ 5(1):1–20. https://doi.org/10.1186/s40862-020-0080-8

    Article  Google Scholar 

  41. Ebu NI, Amissah-Essel S, Asiedu C, Akaba S, Pereko KA (2019) Impact of health education intervention on knowledge and perception of cervical cancer and screening for women in Ghana. BMC Public Health 19(1):1–11. https://doi.org/10.1186/s12889-019-7867-x

    Article  Google Scholar 

  42. Banasik J, Williams H, Haberman M, Blank SE, Bendel R (2011) Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Prac 23(3):135–142. https://doi.org/10.1111/j.1745-7599.2010.00573.x

    Article  Google Scholar 

  43. Manne SL, Siegel S, Kashy D, Heckman CJ (2014) Cancer-specific relationship awareness, relationship communication, and intimacy among couples coping with early-stage breast cancer. J Soc Pers Relat 31(3):314–334. https://doi.org/10.1177/0265407513494950

    Article  PubMed  Google Scholar 

  44. Reese et al (2016) Adapting a couple-based intimacy enhancement intervention to breast cancer: a developmental study. Physiol Behav 35(10):1085–1096. https://doi.org/10.1037/hea0000413

    Article  Google Scholar 

  45. Zimmermann T (2015) Intimate relationships affected by breast cancer: interventions for couples. Breast Care 10(2):102–108. https://doi.org/10.1159/000381966

    Article  PubMed  PubMed Central  Google Scholar 

  46. Devito NJ, Goldacre B (2019) Catalog of bias: publication bias. BMJ Evidence-Based Medicine 24(2):53–54. https://doi.org/10.1136/bmjebm-2018-111107

    Article  PubMed  Google Scholar 

  47. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane handbook for systematic reviews of interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.

Download references

Funding

The Ministry of Finance supported this work, the Republic of Indonesia through the Education Fund Management agency (No. KET-130/LPDP.4/2021).

Author information

Authors and Affiliations

  1. Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424

    Atun Raudotul Ma’rifah, Yati Afiyanti & Yelmi Reni Putri

  2. Harapan Bangsa University Purwokerto, Jl. Raden Patah no 100 Ledug Kembaran Banyumas, Central Java, Indonesia

    Atun Raudotul Ma’rifah

  3. Institute Kesehatan Prima Nusantara Bukit Tinggi, Hermina Hospital Group, Gn. Sahari Sel, Jl. Selangit, RW.10, Kec. Kemayoran, Central Jakarta, Capital Region of Jakarta, Indonesia, 10620

    Mega Hasanul Huda

  4. Kamuzu College of Nursing, Lilongwe, Malawi

    Roselyn Chipojola

  5. Fort De Kock University, Jl. Soekarno Hatta No. 11, Manggis Ganting, Mandingin, Kota Selayan-Kota Bukit Tinggi West Sumatra, Indonesia

    Yelmi Reni Putri

  6. National Library of the Republik of Indonesia, Salemba Raya, 28 A. Kenari, Senen, Central Jakarta, Capital Region of Jakarta, Indonesia

    M. A. Tantawi Nasution

Authors
  1. Atun Raudotul Ma’rifah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yati Afiyanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mega Hasanul Huda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roselyn Chipojola
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yelmi Reni Putri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. A. Tantawi Nasution
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the manuscript conception and writing. ARM, MT, and YA performed study conception, material preparation, data collection, and analysis. The first draft of the manuscript was written by ARM, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yati Afiyanti.

Ethics declarations

Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ma’rifah, A.R., Afiyanti, Y., Huda, M.H. et al. Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 30, 8271–8285 (2022). https://doi.org/10.1007/s00520-022-07277-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-022-07277-y

Keywords

Search

Navigation