Ram, S., Narayanasamy, R., & Barua, A. (2013). Effectiveness of group psycho-education on well-being and depression among breast cancer survivors of Melaka, Malaysia. Indian Journal of Palliative Care, 19(1), 34–39.

Determine the effectiveness of group psycho-education on well-being and depression among breast cancer survivors in Malaysia

In this cluster, non-randomized trial conducted over a one-month period, 34 adult women with non-metastatic breast cancer participated in a group psycho-education class on well-being status and depression. The class was designed to inform and discuss cancer and treatment. They were evaluated with a pre/post-test questionnaire, as well as a pretest socio-demographic questionnaire.

• N = 34    
• AGE = Older than 18 years; 47% older than 50 years; 26.5% for both 30–49 years and younger than 30 years
• MALES: 0%, FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Non-metastatic breast cancer on appropriate medications
• OTHER KEY SAMPLE CHARACTERISTICS: 70.6% were married; 47% completed secondary level of education, 32.3% completed primary level of education, and 20.6% completed college level of education; 29.4% were employed; comorbid conditions: 55.6% had hypertension, 44.4% had diabetes, and 22.2% had both

• SITE: Single site 
• SETTING TYPE: Outpatient 
• LOCATION: Melaka, Malaysia

PHASE OF CARE: Active antitumor treatment

Cluster, non-randomized trial

• Pre-test questionnaire for socio-demographic profile
• World Health Organization (Five) Well-being Index (WHO-5 Well-being Index)

The study showed that psycho-education decreased depression and increased the state of well-being among participants. Post-test results significantly improved for three of the five items on the WHO-5 Well-being Index.

Psycho-education may be one way to improve the overall well-being of patients diagnosed with breast cancer. More research is needed with larger numbers and a multi-site setting to validate improved well-being.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Risk of bias (no appropriate attentional control condition)  
• Risk of bias(sample characteristics)
• Measurement/methods not well described
• Measurement validity/reliability questionable
• Findings not generalizable
• Only women included; findings not generalizable because of small size
• Measurement of well-being not clearly reflective of anxiety or depression

Psycho-education may be one way to improve the overall well-being of patients diagnosed with breast cancer, but as nursing professionals, taking a holistic approach to patient care and recognizing and addressing other contributing factors, such as biological and social factors, are important.