Johannsen, M., Farver, I., Beck, N., & Zachariae, R. (2013). The efficacy of psychosocial intervention for pain in breast cancer patients and survivors: A systematic review and meta-analysis. Breast Cancer Research and Treatment, 138, 675–690.

STUDY PURPOSE: To systematically review and quantify research on the effect of psychosocial interventions on pain in patients with breast cancer

TYPE OF STUDY: Meta-analysis and systematic review

DATABASES USED: Cochrane, PubMed, PsycINFO, EMBASE, Web of Science

KEYWORDS: breast cancer; pain; cancer-related pain; intervention; psychosocial; yoga; mindfulness; meditation; hypnosis; psycho-education; therapy

INCLUSION CRITERIA: Data on a psychosocial intervention; baseline and post-intervention pain measures; data on breast cancer populations; quantitative research

EXCLUSION CRITERIA: Patients younger than 18 years; non-English speaking; non-peer reviewed

TOTAL REFERENCES RETRIEVED = 163

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Independently reviewed by two raters who disagreed on 13 (8.7%); 0.71 kappa statistic for inter-rater agreement

• FINAL NUMBER STUDIES INCLUDED = 26
• TOTAL PATIENTS INCLUDED IN REVIEW = 2,193 women; 1,786 in analysis
• KEY SAMPLE CHARACTERISTICS: Patients with stage I–IV breast cancer; majority had completed treatment
   

• PHASE OF CARE: Multiple phases of care     
• APPLICATIONS: Elder care, palliative care

Psychosocial interventions overall were found to be effective. Robust effect size was found (g = 0.37) [95% CI 0.2–0.4]) but was smaller (g = 0.21) when adjusted for publication bias. Patient education approaches yielded a larger effect (g = 0.64) than supportive group therapy (g = 0.17).

Psychosocial interventions are effective in reducing pain in patients with breast cancer. Patient education and supportive group therapy appear to be the most effective interventions.

• Quality of research papers varied.
• Pain was not the primary outcome in most studies.

Nurses should employ psychosocial interventions to help ameliorate pain in patients with breast cancer. Education and support group interventions should be used initially because they appear to yield the greatest benefit.