Review: Improving subjective perception of personal cancer risk: systematic review and meta-analysis of educational interventions for people with cancer or at high risk of cancer
Door annelies_verachtert op Ma, 30/06/2014 - 00:00
Abstract: Newly diagnosed patients with cancer require education about the disease, the available treat- ments and potential consequences of treatment. Greater understanding of cancer risk has been found to be associated with greater health-related quality of life, improved psychological adjustment and greater health-related behaviours. The aim of this sytematic review was to assess the effectiveness of educational interventions in improving subjective cancer risk perception and to appraise the quality of the studies.
Methods: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective observational studies. Eligible studies were identified via Medline, PsycINFO, AMED, CINAHL and Embase databases. After screening titles and abstracts, two reviewers indepen- dently assessed the eligibility of 206 full-text articles.
Results: Forty papers were included in the review; the majority of studies were conducted among breast cancer patients (n = 29) and evaluated the effect of genetic counselling on personal perceived risk (n = 25). Pooled results from RCTs (n = 12) showed that, both in the short and long term, educa- tional interventions did not significantly influence risk perception level (standardised mean difference 0.05, 95% CI 0.24–0.34; p = 0.74) or accuracy (odds ratio = 1.96, 95% CI: 0.61–6.25; p = 0.26). Only one RCT reported a short-term difference in risk ratings (p = 0.01). Of prospective observational stud- ies (n = 28), many did demonstrate changes in the level of perceived risk and improved risk accuracy and risk ratings in both the short and long term. However, only one (of three) observational studies reported a short-term difference in risk ratings (p < = 0.003).
Conclusion: Further development and investigation of educational interventions using good quality, RCTs are warranted.
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