Ohlsson-Nevo, E., Karlsson, J., & Nilsson, U. (2016). Effects of a psycho-educational programme on health-related quality of life in patients treated for colorectal and anal cancer: A feasibility trial. European Journal of Oncology Nursing, 21, 181–188. 

To evaluate the effects of a psychoeducational program on quality of life (QOL) among patients treated for colorectal and anal cancer

After patients were discharged post-initial surgery, they were invited to participate in the program. Patients completed a baseline assessment and then were randomized to the study program or usual care. Patients in the control group received standard care, including a phone call on postoperative day 3, a follow-up surgical visit after one month, and an appointment with the social worker/counselor if desired. Control group participants were offered the educational program after the end of the study. The intervention included seven meetings with informational lectures delivered once weekly in groups of about 10 patients. Caregivers could attend educational sessions. Lectures were followed by group discussion among patients only to reflect on the topic among peers and speak about worries and experiences. Study assessments were done at 1, 6, and 12 months after study entry.

• N = 86   
• MEAN AGE = 66 years
• MALES: 62.8%, FEMALES: 37.2%
• CURRENT TREATMENT: Chemotherapy, radiation, combination radiation and chemotherapy
• KEY DISEASE CHARACTERISTICS: Colorectal or anal cancer, most were stage I or II 
• OTHER KEY SAMPLE CHARACTERISTICS: The majority were retired and currently married.

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: Sweden

• PHASE OF CARE: Multiple phases of care

• Randomized, controlled trial with wait-list control–longitudinal repeated measures

• Short Form 36 Health Survey (SF-36)

At one month, the intervention group reported better overall mental health status (effect size = 0.51, p = 0.01). Bodily pain score were more positive in the intervention group at six months (p = 0.01), but not significantly different from that of control patients at any other time point, although among the intervention group, average pain scores improved over time, while among controls remained essentially stable.

The psychoeducational program evaluated here was associated with better mental health status and bodily pain subscale scores over time.

• Small sample (< 100)
• Baseline sample/group differences of import
• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Key sample group differences that could influence results
• Measurement validity/reliability questionable
• At baseline, those in the intervention group had significantly higher reported general health and social functioning and better pain scores.
• Repeated measures design with possible testing effects

The psychoeducational program tested here appeared to have positive health-related QOL benefits for participants. Ongoing research is needed to identify the most beneficial timing, amount, content, and format of educational and counseling for short- and long-term benefit to patient with various cancer types and treatment regimens.