Xiao, F., Song, X., Chen, Q., Dai, Y., Xu, R., Qiu, C., & Guo, Q. (2016). Effectiveness of psychological interventions on depression in patients after breast cancer surgery: A meta-analysis of randomized controlled trials. Clinical Breast Cancer. Advance online publication.
DOI Link
Purpose
STUDY PURPOSE: To assess the effectiveness of Cognitive Behavioral Therapy (CBT) or CBT approach interventions for improving depressive symptoms
TYPE OF STUDY: Meta-analysis and systematic review
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 13
- TOTAL PATIENTS INCLUDED IN REVIEW = 966
- SAMPLE RANGE ACROSS STUDIES: Not provided
- KEY SAMPLE CHARACTERISTICS: Women with breast cancer who had undergone surgery
Phase of Care and Clinical Applications
PHASE OF CARE: Not specified or not applicable
Results
Analysis was conducted for each type of outcome measurement instrument used in the research. Across eight studies using the Self-Rating Depression Scale (SDS), the effect of the intervention was seen to be beneficial (standard mean difference [SMD] = –0.87, p < 0.0001). The pooled results of three studies for effects using the Hospital Anxiety and Depression Score (HADS) was also in favor of the intervention (SMD = –0.50, p = 0.04). Across all studies, the SMD comparing CBT to control was –0.92 (p < 0.00001).
Conclusions
Individually delivered CBT was shown to be effective in reducing the symptoms of depression among women with breast cancer.
Limitations
In some studies, different cognitive behavioral approaches were used, and some delivered the intervention via a combination of face-to-face and telephonic contact. The results of the study quality evaluation were not reported. All studies excluded patients with major depression diagnoses.
Nursing Implications
Interventions using cognitive behavioral approaches can be effective to reduce the symptoms of depression in women having undergone surgery for breast cancer. Although full CBT is generally delivered by trained therapists, nurses can incorporate many of these principles into general patient teaching, counseling, and support. Patients with significant depression should be referred for appropriate management as needed.