title: Effect of telehealth intervention on breast cancer patients' quality of life and psychological outcomes: A meta-analysis.
abstract: Introduction Telehealth intervention has been proposed as an innovative intervention approach to breast cancer patients, but there are still conflicting results in the literature about its effect. Methods PubMed, EMBASE, CENTRAL and China National Knowledge Infrastructure (CNKI) were searched from inception to 3 October 2016 for randomized controlled trials (RCTs) which assessed the effect of telehealth intervention versus usual care in breast cancer patients. No language restrictions were used. Standardized mean difference (SMD) with corresponding 95% confidence interval (95% CI) was pooled when needed. Subgroup and sensitivity analyses were conducted if necessary and feasible. Results Twenty RCTs with a total of 2190 participants were included into this meta-analysis. Compared with usual care, telehealth intervention was associated with higher quality of life (SMD = 0.60, 95% CI 0.18-1.01, p = 0.005) and self-efficacy (SMD = 0.59, 95% CI 0.19-0.98, p = 0.003), with less depression (SMD = -1.29, 95% CI -2.28 to -0.30, p = 0.01), distress (SMD = -0.25, 95% CI -0.40 to -0.10, p = 0.001) and perceived stress (SMD = -0.30, 95% CI, -0.59 to -0.02, p = 0.04). However, anxiety score did not differ significantly between the two groups (SMD = -0.09, 95% CI -0.22 to 0.04, p = 0.17). Discussion Telehealth intervention is superior to usual care in breast cancer patients for improved quality of life, higher self-efficacy and less depression, distress, and perceived stress. However, these results should be recognized cautiously due to between-study heterogeneity, indicating that further well-designed RCTs are warranted.
authors.affiliation: 1 School of Nursing, Jinan University, Guangzhou, China.|2 The First Affiliated Hospital of Jinan University, Guangzhou, China.
authors.forename: Yan-Ya
authors.initials: YY
authors.lastname: Chen
authors.affiliation: 3 Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China.
authors.forename: Bing-Sheng
authors.initials: BS
authors.lastname: Guan
authors.affiliation: 1 School of Nursing, Jinan University, Guangzhou, China.
authors.forename: Ze-Kai
authors.initials: ZK
authors.lastname: Li
authors.affiliation: 1 School of Nursing, Jinan University, Guangzhou, China.|2 The First Affiliated Hospital of Jinan University, Guangzhou, China.
authors.forename: Xing-Yi
authors.initials: XY
authors.lastname: Li
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D002681:China; D003863:Depression / Q000517:prevention & control; D005260:Female; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy; D017216:Telemedicine / Q000379:methods*
keywords: Breast cancer; meta-analysis; psychological outcomes; quality of life; telehealth intervention