Effects of Cognitive Behavioral Therapy on Adult Cancer Patients’ Resilience: A Systematic Review and Meta-Analysis

Abstract

Abstract PURPOSE Resilience is ability, outcomes, or processes to an individual's ability to adapt well in the face of significant adversity, which can improve the people’s coping strategies, decrease the level of psychological distress; however, the effect of psychological therapies for resilience remains unknow. Therefore, we systematically evaluate the effect of psychological therapies on the resilience in cancer patients. METHODS We conducted keyword-based searches in PubMed, Cochrane, PsycINFO, CINAHL, and Embase databases. Two researchers independently conducted a strict evaluation for the overall quality of evidence by using the GRADE system and independently performed a data extraction, take meta-analysis by calculating the effect size of the experimental group, exploring the effects of psychological therapies on increasing resilience (PROSPERO registration no.:CRD42021256841). RESULTS There were 12 RCTs (all studies were included in meta-analysis) which be reprsented by Cohen’g were found both at the phase of post-intervention ( Z=4.98; 95% CI, 0.767 to 1.762; p<0.001) and at follow up (Z= 3.71; 95% CI, 0.9 to 1.819; P<0.001). The effect of face-to-face CBTs (Z=14.07) were larger than those of online CBTs (Z=10.72, β=0.85;P=0.02). A GRADE evaluation revealed evidence of sufficient strength for the effect of CBTs on psychological resilience. CONCLUSIONS Psychological therapies can significantly improve the resilience in cancer patients, which maintained at follow up. The most widely used skills in CBTs is rumination, attentional bias and cognitive modification, which committed to changing the way of thinking in which the patients relates to his or her past inner experiences. Future researches could investigate how to further optimize psychological therapies to enhancing cancer patients’ resilience.