Does psychological intervention nursing have high value in improving the quality of life of breast cancer patients?

Studies have shown that psychological intervention nursing (PIN) can alleviate negative emotional reactions in cancer or non-cancer patients (1,2). Recently, Li and colleagues performed a meta-analysis entitled “Systematic review and meta-analysis of the efficacy and safety of psychological intervention nursing on the quality of life of breast cancer patients” (3) to analyze the value of PIN in improving the quality of life of breast cancer patients.

The results showed that PIN can significantly improve the quality of life of patients who underwent radical mastectomy, which has certain guiding significance for clinical development of effective nursing measures. Although the authors have discussed some shortcomings of the article, several limitations should be noticed.

To begin with, there are some flaws in the literature search. First, the investigators did not provide us with detailed search strategy and manual search protocol in this paper. Moreover, only three electronic databases (PubMed, Medline, and Embase) were systematically searched for English studies. Thus, more electronic databases such as Web of Science, Scopus and Cochrane Library are recommended to search relevant literatures to make this study unassailable.

Second, regarding the quality evaluation criteria of including randomized controlled trials (RCTs). The authors claimed that allocation concealment did not use in any of the studies. However, after carefully reviewing Fig. 2 and Fig. 3, we found that 5 studies got low risk in allocation concealment.

Third, the authors claimed there is a significant heterogeneity exists the included studies in the results section. It is essential to identify the source of heterogeneity. The covariates such as intervention (mindfulness-based stress reduction versus mindfulness meditation), country (China versus not China), year of publication (before 2010 versus after 2010), rating scale [Quality of Life Questionnaire Core 30 (QLQ-C 30) versus Short Form 36 Questionnaire (SF-36)] and sample size (>40 versus <40 cases) might be considered when perform the meta regression and subgroup analyses to explore potential sources of heterogeneity.

Finally, the authors clarified that no publication bias and high accuracy of the studies in Fig. 5, Fig. 7 and Fig. 9. However, funnel plot was used to evaluate publication bias in more than 10 articles. We suggest the author to perform Egger’ test to evaluate publication bias.

In summary, Li et al. carried out a good-quality meta-analysis to assess the efficiency of PIN in breast cancer patients. In our view, the role of PIN in breast cancer patients should be studied further, studies with large samples are needed for the literature to know the precise role of PIN in breast cancer patients.

The article’s supplementary files as