Interventions to enhance self‐efficacy in cancer patients: A meta‐analysis of randomized controlled trials

Abstract

Objective: Self-efficacy expectations are associated with improvements in problematic outcomes widely considered clinically significant (ie, emotional distress, fatigue, and pain), related to positive health behaviors, and as a type of personal agency, inherently valuable. Self-efficacy expectancies, estimates of confidence to execute behaviors, are important in that changes in self-efficacy expectations are positively related to future behaviors that promote health and well-being. The current meta-analysis investigated the impact of psychological interventions on self-efficacy expectations for a variety of health behaviors among cancer patients. Methods: Ovid Medline, PsycINFO, CINAHL, EMBASE, Cochrane Library, and Web of Science were searched with specific search terms for identifying randomized controlled trials (RCTs) that focused on psychologically based interventions. Included studies had (a) an adult cancer sample, (b) a self-efficacy expectation measure of specific behaviors, and (c) an RCT design. Standard screening and reliability procedures were used for selecting and coding studies. Coding included theoretically informed moderator variables.Results: Across 79 RCTs, 223 effect sizes, and 8678 participants, the weighted average effect of self-efficacy expectations was estimated as g = 0.274 (P < .001).Consistent with the self-efficacy theory, the average effect for in-person intervention delivery (g = 0.329) was significantly greater than for all other formats (g = 0.154, P = .023; eg, audiovisual, print, telephone, and Web/internet). Conclusions: The results establish the impact of psychological interventions on self-efficacy expectations as comparable in effect size with commonly reported outcomes (distress, fatigue, pain). Additionally, the result that in-person interventions achieved the largest effect is supported by the social learning theory and could inform research related to the development and evaluation of interventions.

Self‐stigma and quality of life among Chinese American breast cancer survivors: A serial multiple mediation model

“…Based on our findings, resources need to be allocated to alleviating survivors' excessive concerns and facilitating their self‐efficacy for coping in order to improve QOL. For example, cognitive–behavioral therapy has shown promise for reducing cancer survivors' concerns and improving self‐efficacy 37,38 . In addition, healthcare providers may devote more time to inquiring about survivors' concerns and addressing these concerns through responsive and supportive communication.…”

Self‐efficacy and return to work in cancer survivors: Current knowledge and future prospects

“…pain, physical activity, coping with cancer and stress management). This study also revealed a small/medium effect size of physical activity on cancer patients’ SE (Merluzzi et al., 2019).…”

“…To evaluate the effectiveness of interventions aimed at increasing RTW-SE and promote RTW in cancer patients, randomised controlled trials should be conducted. For example, a meta-analysis conducted by Merluzzi et al (2019) revealed medium effect sizes of complementary/integrative medicine, social support, cognitive behaviour therapy and self-management interventions in enhancing cancer patients' SE related to specific behaviours (e.g. pain, physical activity, coping with cancer and stress management).…”

“…For example, a meta‐analysis conducted by Merluzzi et al. (2019) revealed medium effect sizes of complementary/integrative medicine, social support, cognitive behaviour therapy and self‐management interventions in enhancing cancer patients’ SE related to specific behaviours (e.g. pain, physical activity, coping with cancer and stress management).…”

Supporting patients and carers affected by pancreatic cancer: A feasibility study of a counselling intervention

“…In the area of cancer and palliative care, self-efficacy theory has been applied in symptom management for patients and for caregivers providing assistance (Given et al, 2006;Kurtz et al, 2005). Further, self-efficacy strategies, including personal mastery, vicarious experiences, verbal persuasion, and physiologic feedback, have also been applied in psychosocial interventions to help cancer patients and caregivers foster perceptions of their capacity to cope with unpredictable and stressful situations (Lee et al, 2016;Leow et al, 2015;Merluzzi et al, 2019). This framework aligns clearly with the sense of helplessness patients experience when faced with this diagnosis which is associated with poor prognosis and high disease burden.…”