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Effects of Psychotherapy on Hope/Hopelessness in Adults with Cancer: a Systematic Review and Meta-analysis

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Abstract

Background

Although psychotherapy is a common treatment for hopelessness and hope, the effectiveness remains controversial. The purpose of this study was to quantitatively synthesize available evidence related to the effect of a broad range of psychotherapy interventions on hope/hopelessness in cancer patients.

Method

Eight electronic databases were searched for studies with adult cancer patients (mean age ≥ 18 years) receiving psychotherapy interventions with hope/hopelessness measured as outcomes and written in English. We used the random-effects model to compute effect size using Hedges’ g and conducted moderator analyses.

Results

We found 27 primary studies which included 1,998 participants who were 57.6 ± 8.0 years old across studies. The psychotherapy effect size ranged from − 0.86 to 2.92. Researchers who conducted psychotherapy at hospital/health centers showed higher effects, that is, improved hope scores (g = 0.63), than those who conducted psychotherapy in the community (g = 0.05). When researchers enrolled participants alone, psychotherapy resulted in higher effects (g = 0.62) than when partners/caregivers were involved (g = − 0.04). Researchers who included group discussion showed lower effects (g = 0.36) than without group discussion (g = 1.10). Researchers who examined fidelity found lower effects (g = 0.16) than researchers who did not examine fidelity (g = 0.66). Interestingly, researchers who studied people with breast cancer showed higher effects (g = 0.96) than those who studied people with other types of cancer (g = 0.26). Researchers who included higher percentages of women showed greater effects (slope = 0.008, Qmodel = 3.99, p = 0.046). Finally, the greater the time span between psychotherapy and the measurement of hope, the lower the psychotherapy effects (slope = − 0.002, Qmodel = 4.25, p = 0.039).

Conclusion

Psychotherapy had a solid moderate effect on reducing hopelessness and improving hope in cancer patients compared to controls.

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Data Availability

All data were taken from published articles.

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Acknowledgements

The authors acknowledge Mary M. Krieger, MLIS, RN, for her expertise and valuable time helping with the search.

Funding

This research was funded from China Scholarship Council (CSC) (File No.201908525079). 

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Authors and Affiliations

  1. School of Nursing, Guizhou Medical University, The Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, China

    Jing Luo & Lixiang Li

  2. Trudy Busch Valentine School of Nursing, Saint Louis University, MO, St. Louis, USA

    Chuntana Reangsing & Joanne Kraenzle Schneider

  3. School of Nursing, Mae Fah Luang University, Chiang Rai, Thailand

    Chuntana Reangsing

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  1. Jing Luo
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Contributions

Study design: Jing Luo, Lixiang Li, and Joanne Kraenzle Schneider; search strategy and literature retrieve: Jing Luo; title, abstract, and full-text review: Jing Luo and Lixiang Li; data coding: Jing Luo, Lixiang Li, and Chuntana Reangsing; data entering: Jing Luo and Lixiang Li; data cleaning: Jing Luo, Lixiang Li, Chuntana Reangsing, and Joanne Kraenzle Schneider; data analysis: Chuntana Reangsing and Joanne Kraenzle Schneider; original draft: Jing Luo, Lixiang Li; revisions of the manuscript and final draft: Jing Luo, Lixiang Li, Chuntana Reangsing, and Joanne Kraenzle Schneider.

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Correspondence to Jing Luo.

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Luo, J., Li, L., Reangsing, C. et al. Effects of Psychotherapy on Hope/Hopelessness in Adults with Cancer: a Systematic Review and Meta-analysis. Int.J. Behav. Med. 29, 691–704 (2022). https://doi.org/10.1007/s12529-021-10051-9

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