Goerling, U., Jaeger, C., Walz, A., Stickel, A., Mangler, M., & van der Meer, E. (2014). The efficacy of short-term psycho-oncological interventions for women with gynaecological cancer: A randomized study. Oncology, 87, 114–124. 

DOI Link

Study Purpose

To study the effects of two different interventions on anxiety and depression postoperatively

Intervention Characteristics/Basic Study Process

The interventions that were studied included a single educational session and a single session of progressive muscle relaxation delivered between the third and sixth postoperative day to women who had surgery for gynecologic cancers. Women randomly were assigned to intervention groups. Study measures were obtained preoperatively prior to hospital discharge.

Sample Characteristics

  • N = 35  
  • MEAN AGE = 49.4 years (range = 23–79 years)
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Varied tumor types (ovarian and cervical were most common); most had grade-2 disease

Setting

  • SITE: Single-site    
  • SETTING TYPE: Inpatient    
  • LOCATION: Germany

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, noncontrolled trial

Measurement Instruments/Methods

  • Hospital Anxiety and Depression Scale (HADS)
  • Perceived-stress questionnaire
  • NeXus 1 (device for measuring physiological measures, respiratory rate, heart rate, skin conductance, etc.)

Results

Anxiety scores declined significantly in both groups (p < .005), and depression declined significantly in those receiving the educational intervention (p < .001). There were no differences between groups in self-reported stress, and there were no significant changes in physiologic measures.

Conclusions

The findings of this study demonstrate that the interventions tested here may have some benefit; however, the strength of the results is low due to study limitations

Limitations

  • Small sample (< 100)
  • Risk of bias (no control group)
  • Risk of bias (no blinding)
  • Unintended interventions or applicable interventions not described that would influence results
  • Subject withdrawals ≥ 10%  
  • Other limitations/explanation: It could be expected that anxiety levels would decline between preoperative and postoperative states without any intervention. The types of surgery were not described. It could be expected that outcomes at discharge could vary according to the type of surgical procedure performed and expected prognosis. Almost one fourth of participants dropped out of the study.

Nursing Implications

This study does not provide strong evidence in support of educational and muscle relaxation interventions for the reduction of anxiety or depression.