Katz, M.R., Irish, J.C., & Devins, G.M. (2004). Development and pilot testing of a psychoeducational intervention for oral cancer patients. Psycho-Oncology, 13, 642–653.

The intervention involved a 95-page teaching booklet, What to Expect From Your Oral Cancer Surgery: A Guide for Patients and Families. The booklet included information about oral cancer, treatments, and effective coping strategies. Contents were divided into preparing for surgery, postoperative care, and returning home.

In the intervention group, the booklet was given to patients pre- and postoperatively by a nurse experienced in caring for patients with head and neck cancers. The preop session was 60–90 minutes of individual teaching before admission to the hospital for surgery. The predischarge session was 60–90 minutes of individual teaching several days prior to expected discharge from the hospital.

In the control group, patients received standard level of care, which included a preop meeting with the surgeon for consent to treatment as well as a brief description of the illness and treatment. Also included in the preadmission information was a tour of the ward and a team visit from the physician, dietitian, social worker, speech therapist, and enterostomal nurse. No information about coping or emotional difficulties was provided routinely. Measurements were taken at baseline, predischarge, and three months follow-up.

• The sample was comprised of 19 patients newly diagnosed with head and neck cancer who were scheduled for their first surgery.
• The intervention group had 10 patients, and the control (standard care) group had 9 patients.

• Hospital setting
• Toronto, Ontario, Canada

A randomized controlled trial design was used.

• Demographic/disease history tool
• Observer-Rated Disfigurement Scale
• Short Michigan Alcoholism Screening Test (SMAST-13): Used to measure history of alcoholism
• Medical Outcomes Study (MOS) Social Support Survey
• Recent stressful life events checklist for chronically ill populations
• Knowledge questionnaire to measure oral cancer–related knowledge
• Stanford Inventory for Cancer Patient Adjustment (SICPA): Used to measure self-efficacy
• State-Trait Anxiety Inventory (STAI)
• Center for Epidemiologic Studies–Depression scale
• Affect Balance Scale: Used to measure quality of life (QOL)
• Body Image Scale
• Atkinson Life Happiness Rating Scale: Used to measure QOL in medically ill populations
• Illness Intrusiveness Ratings Scale
• EORTC QOL questionnaire: Five-item patient satisfaction survey
• Analysis of stats: Simple ANOVA (group x time interaction)

The authors reported significant improvement in anxiety scores within the intervention group from time 1 to time 3 (t = 2.88, df = 9, p = 0.018).

• The study had a small sample size.
• The intervention was a booklet created by a psychiatrist, head and neck surgeon, health psychologist, head and neck dietitian, head and neck speech-language pathologist, nurse educator, and medical illustrator, with patient focus groups as reviewers. This would be costly to replicate.
• An RN spent 60–90 minutes with each patient/family to teach, both preop and predischarge.