Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta‐analysis of clinical trials

Abstract

BackgroundIt has been increasingly recognized that some people experience post‐traumatic growth (PTG) as a result of struggling with cancer.ObjectiveThis systematic review aims to identify psychosocial interventions that might facilitate PTG in adults with cancer.MethodsA search was conducted in PsycINFO, PubMed, Scopus, the Cochrane Library, and ProQuest up to 16 September 2022. The PRISMA guidelines were followed; all included interventional studies had to comprise 30 or more adults with cancer, using the Posttraumatic Growth Inventory, from 1994 forward.ResultsA total of 2731 articles were retrieved, 1028 of those were screened and 37 unique trials were included (46 articles). A large number of studies were published since 2018 (52.4%), were randomized controlled trials (43.2%), and had group interventions (34.8%), including mainly female participants (83.8%) with a single cancer type (54.1%). Most interventions (75.7%) were moderately to highly effective in increasing PTG (d = 0.65, 95% CI 0.39–0.91) with the most effective interventions using Cognitive Behavioral Therapy (d = 1.24, 95% CI: 0.05–2.44), Mindfulness‐based (d = 0.54, 95% CI = 0.14–0.94) and Education, Peer Support and Health Coaching interventions (d = 0.28, 95% CI: 0.1–0.46). Expression‐based and Positive Psychology‐based approaches also showed promising results. Notably, the majority of studies had a high risk of bias.ConclusionsPTG facilitation is a promising field that should be pursued as it not only allows people with cancer to overcome their trauma but also results in them going over and above their pre‐cancer state, enhancing resilience, health, and well‐being.

Posttraumatic growth in palliative care settings: A scoping review of prevalence, characteristics and interventions

“…Encouragingly, in a recent meta-analysis, Vrontaras and co-workers reported a range of interventions across 37 studies including cognitive behavioural therapy, mindfulness, expressive, educational and psychology-based approaches promoting posttraumatic growth with people with mixed and single types of cancer. 73 They report that overall, these interventions show moderate impact ( d = 0.65), regardless of sample, with cognitive behavioural therapy demonstrating a greater impact ( d = 1.24) that translates to an increase of 12 points to the total of the PTGI score, compared to 2 points in control groups. Although these findings suggest that posttraumatic growth can be facilitated with relaxation, education and self-disclosure in people being treated for or surviving cancer, it is not known whether they can be translated into palliative care settings.…”

“…However, these interventions only indirectly targeted posttraumatic growth and it has been suggested that some cognitive and educational approaches may result in too much distress and be paralysing. 75 Given the demonstrated links between posttraumatic growth and better psychological wellbeing, quality of life and the positive outcomes in those with cancer, 73 there appears to be a need for more work exploring interventions that specifically seek to foster posttraumatic growth in the palliative care setting.…”

Post-traumatic growth among emergency nurses after COVID-19 in Shanghai, China: a qualitative study

“…Therefore, enhancing the resilience of ENs during the restructuring phase can facilitate the achievement of PTG. 31 Resilience, defined as the ability to bounce back when individuals face adversity, trauma, misfortune or change, encompasses positive feedback, self-motivation and a focus on the future. Resilient individuals tend to maintain emotional composure and are more likely to successfully complete cognitive restructuring.…”

Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses

“…This systematic review of meta-analyses and the RE-AIM framework demonstrate that app- and website-based interventions have a wide range of effects and are highly used by different (international and multilingual) patients with cancer. However, the use and accessibility of app- and website-based MBIs for patients with cancer have been constrained because of service fees and patient mobility limitations [ 48 ]; app- and website-based MBIs are mainly conducted in high-income countries. The possible explanation is the distinction between communication and economy; some high-income countries may have national health services in place to promote app- and website-based MBIs, whereas developing nations may not.…”