Table 1.

Overview of Studies Examining Educational Interventions in Women with BC Symptoms

No	Study	Participants	Location	Interventions	Design	Outcome Measures	Results
1	Fukui, et al. 2000	BC patients (N=46)	Japan	Intervention Group: Facilitator-assisted (Group psycho-education, 1.5 hours weekly for 6 weeks) Control Group: the wait-list, no contact with the therapists until the intervention began.	RCT	The Profile of Mood States (POMS) The Mental Adjustment to Cancer (MAC) scale The Hospital Anxiety and Depression Scale (HADS)	In the group psychoeducation group: significant reductions in of POMS total mood disturbance scores (p=.003), and increases in the POMS vigor scores (p=.002) and MAC fighting spirit scores (p=.003) post-intervention. No other differences between groups.
2	Jahraus, et al. 2002	BC patients (N=79)	Canada	1. Intervention Group: Self-help (Interactive video) 2. Control group: Facilitator-assisted (Individual and Group)	Pre-Posttest, no control group	The Toronto Informational Needs Questionnaire-Breast Cancer (TINQ-BC) Information-seeking activities: The Informational Styles Questionnaire (ISQ)	The patient education program significantly increased the perceived knowledge adequacy scores: disease subscale (p = <.01), investigative subscale (p=<.01), treatments subscale (p = <.01), physical functioning (p = .01), psychosocial functioning (p = .01). No other differences between groups.
3	Appleton, et al. 2004	Women who had received BC genetic risk counselling (N=163)	United Kingdom	Intervention Groups: Group 1: Scientific and psychosocial written self-help information related to familial risk of breast cancer Group 2: Scientific written self-help information related to familial risk of breast cancer 3. Control Group: standard care only	RCT	Cancer Worry Scale (CWS) Objective knowledge of breast cancer risk-related topics Impact of Event Scale (IES) Perceived risk Perceived control	There was a significant decrease in cancer worry ,i.e. a significant decrease in scores on the CWS from baseline to postintervention for Group 1 (z = 2.133, p =.033) and Group 3 (z = -2.449, p = .014). The total number of correct responses on the objective knowledge of BC significantly improved between baseline and postintervention for both Group 1 and Group 2 (z = -4.605, p =.000; z = -5.090, p = .000).
4	William, et al.2004	BC patients (N=70)	United States	Intervention Group: Self-help (Audiotapes and written information) Control Group: Information about BC as usual	RCT	The Self-care diary (SCD) The Spielberger State-Trait Anxiety Instrument (STAI)	The self-help education intervention increased the use of recommended self-care behaviors for anxiety on the first SCD (p < .05).
5	Stanton, et al. 2005	BC patients (N= 558)	United States	1.Self-help standard written psychoeducation and peer-modeling videotape (VID) 2. Self-help standard written psychoeducation and peer-modeling videotape and two sessions with a trained cancer educator, and informational Workbook (EDU) 3. Self-help standard written psychoeducation Ccontrol)	RCT	The four-item Short Form-36 (SF-36; subscales: Vitality, Physical Component Summary and Mental Component Summary. The Impact of Events Scale (IES-R) The Center for Epidemiologic Studies-Depression Scale (CES-D) The Posttraumatic Growth Inventory (PTGI) Perceived Preparedness for Re-entry Scale	VID produced significant improvement in Vitality subscale of SF-36 at 6 months relative to CTL (p = .018). No other differences between group.
6	Vallance, et.al. 2007	BC Survivors (N=377)	Canada	Intervention group: Self-help 1. Print Material (PM) Group: written material. 2. Pedometer (PED) Group: Step Pedometer 3. Combination (COM) Group: written material and Step Pedometer CG: Standard recommendation to perform physical activities (PA), no additional intervention materials.	RCT	The leisure score index (LSI) The Functional Assessment of Cancer Therapy-Breast (FACT-B) scale	The BC specific materials and pedometer significantly improved the Quality of Life (p = .003). No other differences between group.
7	Burgess, et al. 2009	Women at risk of developing BC (N=292)	United Kingdom	Core intervention: Self-help psychoeducation booklet) Boosted intervention: Self-help psychoeducation booklet followed by interview)	Within-group before-and-after evaluation, no control group	Knowledge of BC symptoms, knowledge of risk, confidence to detect a change, and disclosure to someone close. The Lerman Breast Cancer Worry Scale	At 1-month postintervention, both psychoeducational interventions increased the mean number of BC symptoms identified (p=.001) in the core intervention group (p=.001 and in the boosted intervention group (p=.001). No other differences between groups.
8	Capozzo, et al. 2010	BC patients (N=29);	Italy	Facilitator-assisted (Group Psychoeducation)	Pre-Posttest, no control group	The Mini-Mental Adjustment to Cancer scale (Mini-MAC)	Reduction in anxious preoccupation subscale of Mini-MAC (p = .003). No significant changes on other subscales.
9	Dastan and Buzlu. 2012	BC patients (N=76)	Turkey	Intervention groups: 1. Facilitator-assisted (Group psycho-education) 2. Self-help (Audiovisual information) Control group: usual care	Pre-Post Test control group design	The Mental Adjustment to Cancer Scale (MACS)	At 6 months, group psychoeducation increased MACS subscales “fighting spirit,” (p = .000), and decreased “helplessness/hopelessness” (p = .000), “anxious preoccupation” (p = .000) and “fatalism” (p = 0.000).
10	Komatsu, et al. 2012	BC patients (N= 82)	Japan	Intervention groups: 1.Self-help kit (written information and video) 2.Facilitator-assisted (Professional-led support groups) Control group: usual care	Pre-Post Test control group design	The Center for Epidemiologic Studies-Depression Scale (CES-D) The Spielberger State-Trait Anxiety Inventory (STAI) Quality of Life (SF-36)	Reduction in mental subscale score of SF-36 between the intervention and the control groups over the study period, but the effect size was small (F = 7 .48, p = .008, η2 = .004). No other differences between groups.
11	Sherman, et al. 2012	BC patients (N = 249)	United States	Intervention groups: 1.Self-help (Videotapes); 2.Facilitator/Counselor assisted (Telephone Counseling) Control group: usual care	RCT	The Profile of Adaptation to Life Clinical Scale (PAL-C) The Self-Report Health Scale (SRHS) The Psychosocial Adjustment to Illness Scale (PAIS) The Breast Cancer Treatment Response Inventory (BCTRI)	Improvement within the telephone counselling group in PAL-C psychological well-being from baseline to adjuvant therapy, followed by a decrease from the adjuvant therapy phase to the ongoing recovery phase (p =.002). Higher side effect distress subscale of the BCTRI in intervention groups (p = .012) from post-surgery to ongoing recovery. No other differences between groups.
12	Jones, et al. 2013	BC patients (N = 442)	Canada	Intervention group: Getting back on track (GBOT) Class Control group: Getting back on track (GBOT) Book.	RCT, no inactive control	1 The Knowledge Regarding Re-Entry Transition (a questionnaire specifically developed to cover the contents of GBOT curriculum) 2. The Perceived Preparedness for Re-Entry Scale (Stanton, et al. 2005) 3. The Self-Efficacy for Managing Chronic Disease Scale 4. The Profile of Mood States Scale-Short Form (POMS-SF) 5. The Medical Outcomes Study (MOS)-Health Distress Scale	Group psychoeducational intervention significantly enhanced (p < .0001) the knowledge regarding the re-entry transition period and their feelings of preparedness for the re-entry phase (p < .0001). No other differences between groups.
13	Ram, et al. 2013	BC patients (N = 34)	Malaysia	Facilitator assisted (Group psycho-education)	A cluster non-randomized trial	The WHO-five Well-being Index (1998 version)	The group psychoeducation improved the proportion of patients in the state of adequate well-being (p <.05) and reduced the proportion of depressed patients (p <.05).

BC, Breast cancer; RCT, Randomize control trials