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Breast cancer, Coping, Intervention, Mental adjustment, Oncology, Psychoeducation



  1. Schou Bredal, Inger PhD, RN
  2. Karesen, Rolf MD, PhD
  3. Smeby, Nina Aarhus PhD, RN
  4. Espe, Randi RN
  5. Sorensen, Elin Myklebust RN
  6. Amundsen, Mette RN
  7. Aas, Hans MD
  8. Ekeberg, Oivind MD, PhD


Background: Limited documentation exists on the effectiveness of psychoeducational group (PEG) versus support group (SG) interventions among breast cancer patients during primary care. Support group is a component of the hospitals' routine breast cancer care.


Objective: The aim of this study was to investigate which of these approaches provides the greatest benefits to participants, particularly to women with low optimism (pessimists). The primary outcomes investigated here were anxiety, depression, and mental adjustment to cancer.


Methods: A total of 367 women with early-stage breast cancer were randomized to the PEG or SG intervention starting 1 to 8 weeks after surgery. The PEG intervention included health education, enhancement of problem-solving skills, stress management, and psychological support.


Results: Participants in both groups showed improvement over time; however, no significant differences in emotional distress were found. The PEG participants exhibited more positive attitude at 2 and 6 months (P < .001) and less helplessness/hopelessness (P = .01) at 2 months compared with the SG participants. However, no significant differences were found between the groups at 12 months. Pessimists did not benefit more from attending the PEG than they did from attending the SG.


Conclusion: Both groups showed improvement in emotional distress and coping over time. Although the results were limited, the PEG intervention seems to enhance short-term, but not long-term, adaptive coping.


Implications for practice: Psychoeducational group intervention yields benefits during the difficult period when patients receive adjuvant chemotherapy or radiotherapy. Thus, the hospital's standard group interventions have been changed to include more health education and stress management, but within the same time frame as the original SG.