Effectiveness of a Structured Psychoeducational Intervention for Gynecologic Cancer Patients: A Randomized Controlled Study
DOI:
https://doi.org/10.5281/zenodo.16783795Anahtar Kelimeler:
jinekolojik kanser, anksiyete, depresyonÖzet
This randomized controlled trial aimed to evaluate the effects of a structured psychoeducational program on illness perception, coping skills, psychological adjustment, and emotional distress in women diagnosed with gynecological cancer. A total of 49 patients with stage I–III gynecological cancer were randomly assigned to either the psychoeducation intervention group (n=22) or the control group receiving standard oncological care (n=27). The six-week group-based intervention was adapted from the Fawzy and Fawzy model and included cancer education, stress management, cognitive restructuring, emotional expression, and coping skills training. Pre- and post-intervention assessments were conducted using validated Turkish versions of the Mental Adjustment to Cancer Scale, Profile of Mood States, Hospital Anxiety and Depression Scale, Beck Depression Inventory, Illness Perception Questionnaire, and Stress Coping Styles Inventory. Non-parametric statistical analyses were employed. The intervention group demonstrated significant improvements in fighting spirit, problem solving, seeking social support, personal control, illness coherence, and mood, as well as significant reductions in helplessness, anxious preoccupation, avoidance coping, fatalism, anxiety, depression, emotional distress, and negative illness perceptions (all p<.05), with medium-to-large effect sizes. No significant changes were observed in the control group. The structured psychoeducational intervention effectively enhances psychological adjustment, reduces distress, and promotes adaptive coping and illness perceptions, suggesting its integration into routine oncology care may improve psychosocial outcomes.
Referanslar
Akyüz, A., Şahiner, G., & Seven, M. (2008). Depression, self-esteem, body image and quality of life in Turkish women with gynecological cancer. Asian Pacific Journal of Cancer Prevention, 9(3), 505–510. https://pubmed.ncbi.nlm.nih.gov/19256742
Alacacıoğlu, A., Yavuzşen, T., Dirioz, M., Öztop, İ., & Demir, L. (2020). The need for psycho-oncology services and training in Turkey. Turkish Journal of Oncology, 35(2), 112–116. https://doi.org/10.5505/tjo.2020.2343
Andersen, B. L., Shelby, R. A., & Golden-Kreutz, D. M. (2007). RCT of a psychological intervention for patients with cancer: I. mechanisms of change. Journal of Consulting and Clinical Psychology, 75(6), 927–938. https://doi.org/10.1037/0022-006X.75.6.927
Antoni, M. H., Lehman, J. M., Kilbourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M., Yount, S. E., McGregor, B. A., Arena, P. L., Harris, S. D., Price, A. A., Baum, A., & Carver, C. S. (2001). Cognitive–behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20–32. https://doi.org/10.1037/0278-6133.20.1.20
Armay, Z., Kocaman, N., & Kutlu, Y. (2007). Hastalık algısı ölçeğinin geçerlik ve güvenirlik çalışması. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 10(2), 1–10.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004
Bodurka-Bevers, D., Basen-Engquist, K., Carmack, C. L., Fitzgerald, M. A., Wolf, J. K., de Moor, C., Hu, S., & Gershenson, D. M. (2000). Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gynecologic Oncology, 78(3), 302–308. https://doi.org/10.1006/gyno.2000.5908
Chow, K. M., Chan, C. W., Choi, K. C., & Chan, C. H. (2016). A randomized controlled trial of a psychoeducational intervention on sexual functioning, quality of life, and psychological distress among patients with gynecological cancers. Psycho‐Oncology, 25(6), 646–654. https://doi.org/10.1002/pon.3887
Classen, C., Butler, L. D., Koopman, C., Miller, E., DiMiceli, S., Giese-Davis, J., Fobair, P., Carlson, R. W., & Spiegel, D. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer: A randomized clinical intervention trial. Archives of General Psychiatry, 58(5), 494-501. https://doi.org/10.1001/archpsyc.58.5.494
Dansuk, R., Gökçü, M., & Aksu, T. (2002). Psychological effects of gynecological cancers. Turkish Journal of Cancer, 32(1), 22–26.
del Carmen, M. G., Montz, F. J., & Bristow, R. E. (2015). Gynecologic cancer disparities. In C. N. Trimble (Ed.), Cancer Disparities: Causes and Evidence-Based Solutions (pp. 105–124). Springer.
Donovan, H. S., Wenzel, L., Ward, S., & Ryan, N. (2022). Health-related quality of life and psychological distress in women with ovarian cancer: A longitudinal study. Journal of Clinical Oncology, 40(15), 1625–1634.
Faller, H., Schuler, M., Richard, M., Heckl, U., Weis, J., & Küffner, R. (2013). Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: Systematic review and meta-analysis. Journal of Clinical Oncology, 31(6), 782–793. https://doi.org/10.1200/JCO.2011.40.8922
Fawzy, F. I., Fawzy, N. W., Arndt, L. A., & Pasnau, R. O. (1990). Critical review of psychosocial interventions in cancer care. Archives of General Psychiatry, 47(8), 720–728. https://doi.org/10.1001/archpsyc.1990.01810200096017
Fawzy, F. I., Cousins, N., Fawzy, N. W., Kemeny, M. E., Elashoff, R., & Morton, D. (1990). A structured psychiatric intervention for cancer patients. I. Changes over time in methods of coping and affective disturbance. Archives of General Psychiatry, 47(8), 720–725.
Fawzy, F. I., Fawzy, N. W., Arndt, L. A., & Pasnau, R. O. (1995). Critical review of psychosocial interventions in cancer care. Archives of General Psychiatry, 52(2), 100-113. https://doi.org/10.1001/archpsyc.1995.03950140018002
Ferlay, J., Soerjomataram, I., Dikshit, R., et al. (2015). Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer, 136(5), E359–E386. https://doi.org/10.1002/ijc.29210
Galway, K., Black, A., Cantwell, M., Cardwell, C. R., Mills, M., & Donnelly, M. (2012). Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database of Systematic Reviews, (11), CD007064. https://doi.org/10.1002/14651858.CD007064.pub2
Greimel, E. R., Winter, R., Kapp, K. S., & Haas, J. (2011). Quality of life and sexual functioning after cervical cancer treatment: A long-term follow-up study. Psycho‐Oncology, 20(10), 1016–1023. https://doi.org/10.1002/pon.1820
Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and Health, 18(2), 141–184. https://doi.org/10.1080/088704403100081321
Hisli, N. (1988). Beck Depresyon Envanteri’nin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi, 6(22), 118–126.
Holland, J. C., & Weiss, T. R. (2010). The new standard of quality cancer care: Integrating the psychosocial aspects in routine cancer from diagnosis through survivorship. Psycho-Oncology, 19(6), 557-560. https://doi.org/10.1002/pon.1787
Hopman, P., Rijken, M., & Schellevis, F. G. (2015). Illness perceptions of cancer patients: Relationships with illness characteristics and coping. Psycho‐Oncology, 24(1), 11–18. https://doi.org/10.1002/pon.3571
Jeppesen, M. M., Mogensen, O., & Dehn, P. (2015). Needs and priorities of women with gynecologic cancer: A national Danish study. Psycho‐Oncology, 24(10), 1138–1144. https://doi.org/10.1002/pon.3819
Kaptein, A. A., Meulman, J., Scharloo, M., Weinman, J., Hazes, J. M., Willems, L. N., Bergman, W., & Rooijmans, H. G. (2015). Using the common sense model to predict quality of life in cancer patients. Psycho‐Oncology, 24(3), 302–309. https://doi.org/10.1002/pon.3640
Kornblith, A. B., Wenzel, L., & Fairclough, D. (2001). Long-term adjustment of survivors of ovarian cancer treated for advanced-stage disease. Journal of Clinical Oncology, 19(15), 3549–3556. https://doi.org/10.1200/JCO.2001.19.15.3549
Lebel, S., Maheu, C., Lefebvre, M., Secord, S., Courbasson, C., Singh, M., & Fung, M. F. K. (2016). Addressing fear of cancer recurrence among women with cancer: A feasibility and preliminary outcome study. Journal of Cancer Survivorship, 10(3), 500–510. https://doi.org/10.1007/s11764-015-0491-6
McNair, D. M., Lorr, M., & Droppleman, L. F. (1971). Profile of Mood States Manual. Educational and Industrial Testing Service.
Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., Cameron, L. D., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology and Health, 17(1), 1–16. https://doi.org/10.1080/08870440290001494
Osborn, R. L., Demoncada, A. C., & Feuerstein, M. (2006). Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: Meta-analyses. International Journal of Psychiatry in Medicine, 36(1), 13–34. https://doi.org/10.2190/EUFN-RV1K-Y3TR-FK0L
Özer, N. (1998). Hastane Anksiyete ve Depresyon Ölçeği: Geçerlik ve güvenirlik çalışması. Yayınlanmamış yüksek lisans tezi, Hacettepe Üniversitesi Sosyal Bilimler Enstitüsü.
Özkan, S., & Özkan, M. (2004). Psychosocial aspects of gynecological cancer: A review. European Journal of Gynaecological Oncology, 25(5), 604–610.
Özkan, S., Yılmaz, A., & Özkan, M. (2013). Training needs in psycho-oncology: A multicenter study in Turkey. Asian Pacific Journal of Cancer Prevention, 14(9), 5251–5255. https://doi.org/10.7314/APJCP.2013.14.9.5251
Schnoll, R. A., Knowles, J. C., & Harlow, L. L. (2002). Correlates of psychosocial adjustment among cancer survivors. Journal of Psychosocial Oncology, 20(1), 37–59. https://doi.org/10.1300/J077v20n01_03
Schofield, P., Gough, K., Lotfi-Jam, K., Aranda, S., & Jackson, M. (2019). Unmet needs of cancer patients: A systematic review of research development and clinical implementation. Supportive Care in Cancer, 27, 2981–2992. https://doi.org/10.1007/s00520-019-04839-6
Sekse, R. J. T., Raaheim, M., Blaaka, G., & Gjengedal, E. (2021). The effect of psychosocial interventions in gynecologic cancer survivors: A systematic review and meta-analysis. European Journal of Oncology Nursing, 50, 101864. https://doi.org/10.1016/j.ejon.2020.101864
Sekse, R. J. T., Dunberger, G., Olesen, M. L., Østerbye, M., Seibaek, L. L., Flobak, T., Hansen, L., & Smith, A. (2023). Psychosocial support interventions for women with gynecologic cancer: An updated meta-review. International Journal of Gynecological Cancer, 33(3), 364–372. https://doi.org/10.1136/ijgc-2022-004030
Selvi, Y., Aydın, A., Atli, A., Beşiroğlu, L., Özdemir, P. G., & Gulec, M. (2010). The validity and reliability of the Turkish version of the Profile of Mood States (POMS). Journal of Mood Disorders, 1(3), 152–161. https://doi.org/10.5455/jmood.20101215023041
Şahin, N. H., & Durak, A. (1995). Stresle Başa Çıkma Tarzları Envanteri: Üniversite öğrencileri için uyarlanması. Türk Psikoloji Dergisi, 10(34), 56-73.
Yang, Y., Koh, L. J., Yap, C. A., Smith, J., Lee, R., Chen, T., Patel, V., & Nguyen, H. (2014). Effectiveness of psychoeducation interventions for sexual dysfunction in cancer patients: A meta-analysis. Supportive Care in Cancer, 22(6), 1615–1626. https://doi.org/10.1007/s00520-014-2131-x
Tamagawa, R., Garland, S. N., Vaska, M., Carlson, L. E. (2012). Who benefits from psychosocial interventions in oncology? A systematic review of psychological moderators of treatment outcome. Journal of Behavioral Medicine, 35(6), 658–673. https://doi.org/10.1007/s10865-012-9396-4
Walker, L. G., Heys, S. D., Walker, M. B., Ogston, K., Miller, I. D., Hutcheon, A. W., Sarkar, T. K., & Eremin, O. (2013). Psychological distress in patients with gynecological cancer. British Journal of Cancer, 88(6), 845–850. https://doi.org/10.1038/sj.bjc.6600794
Wang, T., Molassiotis, A., Chung, B. P. M., & Tan, J. Y. (2020). Unmet care needs and quality of life among advanced cancer patients: A systematic review. Critical Reviews in Oncology/Hematology, 152, 102991. https://doi.org/10.1016/j.critrevonc.2020.102991
Watson, M., Greer, S., Young, J., Inayat, Q., Burgess, C., & Robertson, B. (1988). Development of a questionnaire measure of adjustment to cancer: The MAC scale. Psychological Medicine, 18(1), 203–209.
Weinman, J., Petrie, K. J., Moss-Morris, R., & Horne, R. (1996). The Illness Perception Questionnaire: A new method for assessing the cognitive representation of illness. Psychology & Health, 11(3), 431–445.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600 0447.1983.tb09716.x
Holland, J. C., & Weiss, T. R. (2010). The human side of cancer: Living with hope, coping with uncertainty (2nd ed.). HarperCollins.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing.
Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 65–94). Routledge.
Massie, M. J., Lloyd-Williams, M., & Holland, J. C. (2004). Depression in patients with cancer. In J. C. Holland (Ed.), Psycho-Oncology (pp. 518–531). Oxford University Press.
Natan, İ. (2000). Kanser Teşhisi Almış Hastalarda Kansere Tepki Tarzı Ölçeği’nin (MAC) Güvenilirlik ve Geçerlilik Yönünden İncelenmesi (Yüksek Lisans Tezi). İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü.
Özer, H. (1998). Hastane Anksiyete ve Depresyon Ölçeğinin (HAD) Güvenilirlik ve Geçerliliği (Uzmanlık Tezi). Atatürk Üniversitesi.
Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D. M., Forman, D., & Bray, F. (2015). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. International Agency for Research on Cancer. https://gco.iarc.fr/today/home
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
TKİ (2016). Türkiye Kanser İstatistikleri 2013. Türkiye Halk Sağlığı Kurumu. https://hsgm.saglik.gov.tr
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