META-ANALYSIS OF THE EFFECTS OF THE EDUCATIONAL AND COUNSELING INTERVENTIONS ON MENTAL ADJUSTMENT AND QUALITY OF LIFE IN BREAST CANCER

Background: Education and counselling are widely used independently or as supplementary components in the psychosocial interventions. However, there is a certain level of ambiguity if used separately. In this analysis, we attempted to answer the following question; “Does the education and counseling support improve of the adjustment to cancer in women diagnosed with breast cancer?” Methods: An online search was undertaken in 12 databases for the longitudinal studies for the period from January 2007 to March 2018. The effects of the interventions on the adjustment to breast cancer, were calculated based on the results of the mental adjustment and quality of life (QoL). Three distinct periods were examined; baseline, three months, and six months. The methodological quality, risk of bias, publication bias, and attrition rate were examined. Meta-analysis was carried out using Review Manager 5.3 with the results graphically presented. Results: A comprehensive systematic review was conducted for 5,464 titles, of which 22 studies fulfilled the inclusion criteria, however 14 studies completed the data and included in the qualitative synthesis; included 3,419 patients. The mean of overall attrition rate in both groups was 14.37% (SE= 2.87, median= 12.28). In mental adjustment, the total mean differences for the three trials were statistically significant 0.40 (0.24 to 0.57). For the QoL, the mean differences of the three trials were statistically non-significant 0.18 (-0.48 to 0.84). Conclusion: The educational and/or counseling interventions can be beneficial and useful for patients to adapt with the breast cancer, however, it is less effective on the QoL. Keywords: mental adjustment, quality of life, education, counseling