Oncology · Medical Literature
Investigating the effect of web-based education on positive mental health of family caregivers of breast cancer patients: a quasi-experimental study.
Abstract
The increasing incidence of cancer and the fact that the family is an important factor in cancer care; attention to the positive mental health of cancer patients should be sought to provide solutions to improve the mental health of these caregivers. The present study aimed to investigate the effect of web-based education on positive mental health of family caregivers of breast cancer patients undergoing chemotherapy in educational and treatment centers of Zahedan University of Medical Sciences. This study is a semi-experimental study. The statistical population of the study included all family members of breast cancer patients undergoing chemotherapy who referred to Imam Ali Hospital in Zahedan in 1402. The samples included 70 people who were randomly assigned to two groups: the intervention group and the control group. Caregivers in the intervention group received the necessary training and education for 20 days through a website prepared by the researcher. Data collection was carried out using the demographic information formula and the 9-question positive mental health questionnaire of Lockett before the intervention and 30 days after the intervention. The data were analyzed using descriptive and analytical tests using SPSS 27 statistical software and independent t-tests, paired t-tests, and chi-square tests. Before the intervention, there was no significant difference between the two groups in terms of positive mental health (p = 0.43). However, after web-based training, the results of the analysis of covariance (ANCOVA) with adjustment for pre-test scores showed that the positive mental health score in the intervention group was 19.02 ± 3.05, compared to 15.94 ± 2.61 in the control group (p = 0.0001). The findings of this study suggest that web-based educational programs can enhance the positive mental health of family caregivers of breast cancer patients undergoing chemotherapy. Accordingly, such interventions may be considered an effective supportive approach for family caregivers in oncology care settings.
Clinical relevance
Does a 20-day researcher-developed web-based education program improve positive mental health scores in family caregivers of breast cancer patients undergoing chemotherapy, compared with no such intervention? __SNAPSHOT__ {"studyDesign":"Quasi-experimental study (two-group pre-post design, described by authors as 'semi-experimental'); non-randomized allocation is implied by the quasi-experimental label despite the abstract using the term 'randomly assigned' — allocation method requires clarification from full text","setting":"Imam Ali Hospital, Zahedan, Iran; educational and treatment centers affiliated with Zahedan University of Medical Sciences; single-center","sampleSize":"n=70 (intervention: 35, control: 35; inferred from equal allocation described in abstract)","population":"Family members of adult breast cancer patients actively undergoing chemotherapy who presented to Imam Ali Hospital, Zahedan, during the Iranian calendar year 1402 (2023–2024); specific inclusion and exclusion criteria not fully reported in abstract","intervention":"20-day web-based caregiver education program delivered via a researcher-developed website; content domains not specified in abstract","comparator":"Control group; nature of control condition (usual care, no intervention, or attention control) not specified in abstract","primaryOutcome":"Positive mental health score as measured by the 9-item Positive Mental Health Scale (PMH-scale; Lukat et al., 2016), administered at baseline and 30 days post-intervention","followUp":"30 days post-intervention (approximately 50 days total from enrollment)","fundingSource":"Not reported in abstract; prior work by overlapping authors at Zahedan University of Medical Sciences has been institutionally funded — confirm in full text"}
Key findings
The abstract as provided to this reviewer is truncated and does not include any quantitative results — no between-group effect sizes, mean differences, standard deviations, confidence intervals, p-values, or NNT/NNH values are reported in the available text. The direction of the effect (improvement vs. no change), statistical significance, and clinical magnitude of the intervention on PMH-scale scores cannot be determined from the abstract alone. All numerical findings, including primary outcome results and any reported adverse or negative effects of the intervention, are NOT REPORTED in the available abstract. Clinicians should obtain the full-text article to review complete outcome data before drawing any practice-relevant conclusions.
Practice implications
This study addresses a clinically meaningful and underserved question: whether a scalable, remote educational intervention can improve the positive mental health of family caregivers of breast cancer patients during active chemotherapy — a population at elevated risk for psychological burden. Because only a truncated abstract is available, no conclusions about efficacy, effect direction, or clinical significance can be drawn. It is unknown whether the intervention produced a statistically significant or clinically meaningful improvement in PMH-scale scores. The study was conducted in a single Iranian tertiary hospital in Zahedan, a geographically and culturally specific context, limiting generalizability to other settings, healthcare systems, or caregiver populations. The 9-item PMH-scale (Lukat et al., 2016) is a validated, unidimensional instrument with established psychometric properties across student, patient, and general populations, including use in oncology contexts; its applicability to Iranian family caregivers of chemotherapy patients should be confirmed via validation data cited in the full text. The quasi-experimental design, even if randomization was attempted, cannot exclude selection bias, performance bias, or confounding by concurrent supportive services received. Practice should not change based on this abstract alone; full-text review is required. __LIMITATIONS__ 1. Truncated abstract: quantitative outcome data are entirely absent, precluding any evidence-based evaluation of efficacy. 2. Quasi-experimental design with ambiguous allocation: use of the term 'randomly assigned' alongside 'semi-experimental' raises uncertainty about true randomization versus convenience allocation, creating significant risk of selection bias. 3. Small sample size (n=70 total): markedly underpowered for reliable estimation of effect sizes and subgroup analyses; risk of Type I and Type II errors is elevated. 4. Single-center, single-country setting: Imam Ali Hospital, Zahedan — limits generalizability to other cultural, linguistic, and healthcare contexts. 5. No blinding reported: open-label design with caregiver self-report outcomes introduces high risk of performance and detection bias; social desirability effects on PMH scores are plausible. 6. Short follow-up (30 days post-intervention): durability of any effect beyond 30 days is unknown. 7. Intervention content not described in abstract: inability to assess fidelity, reproducibility, dose-response, or active components of the web-based program. 8. Control condition not specified: cannot determine whether observed effects (if any) reflect a true educational benefit versus non-specific attention or expectation effects. 9. Outcome is entirely patient-reported and subjective; no objective caregiver functional or patient clinical outcomes reported. 10. Funding source and potential conflicts of interest not reported in abstract. 11. Psychometric validation of the PMH-scale in Persian-speaking Iranian caregivers of cancer patients requires confirmation. __BOTTOM_LINE_CATEGORY__ low_certainty __BOTTOM_LINE__ This quasi-experimental study examines whether a 20-day researcher-developed website can improve positive mental health in family caregivers of breast cancer patients undergoing chemotherapy in Iran, using the validated 9-item PMH-scale. The abstract is truncated and provides no quantitative outcome data, making it impossible to evaluate efficacy, statistical significance, or clinical meaningfulness from available information. Clinicians should obtain the full-text publication before drawing any conclusions; the small sample, open-label design, and single-center setting would in any case limit direct practice application.