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Prieto-Crespo V, Arevalo-Buitrago P, Olivares-Luque E, García-Arcos A, López-Soto PJ. Impact of Spiritual Support Interventions on the Quality of Life of Patients Who Receive Palliative Care: A Systematic Review. NURSING REPORTS 2024; 14:1906-1921. [PMID: 39189272 PMCID: PMC11348222 DOI: 10.3390/nursrep14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 07/27/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Palliative care focuses on the prevention of worsening health, improving the quality of the patient's life, and the relief of suffering, and therefore has a considerable impact on both the patient suffering from a life-threatening or potentially life-threatening illness and on their family. Spirituality, as the dimension of human life involving the search for meaning, purpose, and transcendence, and connection with oneself, others, and the sacred, could be essential in supporting these patients. The aim of this study was to synthesise the scientific evidence describing the interventions and/or activities undertaken to meet the spiritual needs of the palliative patient. METHODS A literature search was carried out across the following databases: PubMed, LILACS, Scopus, and Web of Science. The PRISMA statement was used to guide this review. RESULTS Twenty-four articles were included. The thematic categories included spiritual needs at the end of life, the influence of music and dance as palliative care, care for family caregivers, and the comparison between counselling and dignity therapy. CONCLUSIONS Interventions in the biopsychosocial-spiritual spheres impact on the patient's peace of mind and promote the acceptance of a "good death". Healthcare personnel play an essential role in the way their patients prepare for the moment of death, and the meaning and values they convey help them to accompany and welcome patients. Last but not least, universities can play a crucial role by training nurses to integrate spiritual interventions such as music and dance, or by considering the family as a unit of care. The systematic review protocol was registered in the Prospective International Register of Systematic Reviews (PROSPERO) under protocol number CRD42023490852.
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Affiliation(s)
| | - Pedro Arevalo-Buitrago
- Critical Care Service, Reina Sofia University Hospital, Avda. Menendez Pidal s/n, 14004 Córdoba, Spain;
- Department of Nursing, Pharmacology and Physiotherapy, Cordoba University, Avda Menendez Pidal s/n, 14071 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, Avda. Menendez Pidal s/n, 14004 Córdoba, Spain
| | | | - Aurora García-Arcos
- Critical Care Service, Reina Sofia University Hospital, Avda. Menendez Pidal s/n, 14004 Córdoba, Spain;
| | - Pablo Jesús López-Soto
- Department of Nursing, Pharmacology and Physiotherapy, Cordoba University, Avda Menendez Pidal s/n, 14071 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, Avda. Menendez Pidal s/n, 14004 Córdoba, Spain
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Izgu N, Metin ZG, Eroglu H, Semerci R, Pars H. Impact of spiritual interventions in individuals with cancer: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 71:102646. [PMID: 38943773 DOI: 10.1016/j.ejon.2024.102646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/05/2024] [Accepted: 06/14/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life. METHODS Between 2012 and May 2024, the Cochrane Library, Scopus, PubMed, and Web of Science were searched considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Twenty-six randomized controlled trials were included, and 16 were synthesized in the meta-analysis. Bias risk was evaluated using the Cochrane risk-of-bias methodology for randomized studies. The Grading of Recommendations, Assessment, Development, and Evaluations tool was employed for evidence certainty. Heterogeneity was expressed through I2 and Q statistics. Hedge's g was calculated for effect sizes. Egger's and Kendall's Tau were used for publication bias. RESULTS Spiritual interventions yielded beneficial effects on fatigue (Hedges's g = 0.900, p < 0.001) and pain (Hedges's g = 0.670, p < 0.001) but not for overall symptom burden (Hedges's g = 0.208, p = 0.176). Significant effects were found for anxiety (Hedges's g = 0.301, p < 0.001), depression (Hedges's g = 0.175, p = 0.016), and psychological distress (Hedges's g = 0.178, p = 0.024), except for hopelessness (Hedges's g = 0.144, p = 0.091). Spiritual interventions enhanced faith (Hedges's g = 0.232, p = 0.035), the meaning of life (Hedges's g = 0.259, p = 0.002), spiritual well-being (Hedges's g = 0.268, p < 0.001), and quality of life (Hedges's g = 245, p < 0.001). Moderator analysis pointed out that cancer stage, total duration, delivery format, providers' qualification, content, and conceptual base of spiritual interventions significantly affect physical, emotional, and spiritual outcomes and quality of life. CONCLUSION This meta-analysis highlighted the benefits of spiritual interventions with varying effect sizes on patients' outcomes, as well as quality of life in cancer, and shed on how to incorporate these approaches into clinical practice.
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Affiliation(s)
- Nur Izgu
- Hacettepe University Faculty of Nursing, Internal Medicince Nursing Department, Ankara, Turkey.
| | - Zehra Gok Metin
- Hacettepe University Faculty of Nursing, Internal Medicince Nursing Department, Ankara, Turkey
| | - Hacer Eroglu
- Healthcare Vocational School, Lokman Hekim University, Ankara, Turkey
| | - Remziye Semerci
- Department of Pediatric Nursing, School of Nursing, Koç University, İstanbul, Turkey
| | - Hatice Pars
- Epidemiology MSc Program, The Institute of Health Sciences, Hacettepe University, Ankara, Turkey
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Mascaro JS, Florian MP, Brauer E, Palmer PK, Ash MJ, Shelton M, Palitsky R, Kaplan DM, Rana S, Escoffery C, Raison CL, Grant GH. A mixed-method evaluation of implementation determinants for chaplain intervention in a hospital setting. J Health Care Chaplain 2024; 30:226-244. [PMID: 38620020 PMCID: PMC11213669 DOI: 10.1080/08854726.2024.2323375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Healthcare chaplains address broad social and emotional dimensions of care within a pluralistic religious landscape. Although the development and evaluation of chaplaincy interventions has advanced the field, little research has investigated factors influencing the implementation of new chaplain interventions. In this mixed-method study, we examined attitudes about evidence-based interventions held by chaplain residents (n = 39) at the outset of an ACPE-accredited residency program in the southeast United States. We also used semi-structured interviews (n = 9) to examine residents' attitudes, beliefs, and decision-making processes after they trained in the delivery of a novel manualized intervention, Compassion-Centered Spiritual Health (CCSH). Most residents reported favorable attitudes toward manualized approaches prior to training. Interviews revealed complex decision-making processes and highlighted personal motivations and challenges to learning and implementing CCSH. Implementation science can reveal factors related to motivation, intention, and training that may be optimized to improve the implementation of healthcare chaplaincy interventions.
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Affiliation(s)
- Jennifer S Mascaro
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
| | - Marianne P Florian
- Department of Religious Studies, University of South Florida, Tampa, FL, USA
| | - Erin Brauer
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Patricia K Palmer
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
| | - Marcia J Ash
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Maureen Shelton
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
| | - Roman Palitsky
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
| | - Deanna M Kaplan
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
| | - Shaheen Rana
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Charles L Raison
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA
| | - George H Grant
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, GA, USA
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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4
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Sanders JJ, Temin S, Ghoshal A, Alesi ER, Ali ZV, Chauhan C, Cleary JF, Epstein AS, Firn JI, Jones JA, Litzow MR, Lundquist D, Mardones MA, Nipp RD, Rabow MW, Rosa WE, Zimmermann C, Ferrell BR. Palliative Care for Patients With Cancer: ASCO Guideline Update. J Clin Oncol 2024; 42:2336-2357. [PMID: 38748941 DOI: 10.1200/jco.24.00542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE To provide evidence-based guidance to oncology clinicians, patients, nonprofessional caregivers, and palliative care clinicians to update the 2016 ASCO guideline on the integration of palliative care into standard oncology for all patients diagnosed with cancer. METHODS ASCO convened an Expert Panel of medical, radiation, hematology-oncology, oncology nursing, palliative care, social work, ethics, advocacy, and psycho-oncology experts. The Panel conducted a literature search, including systematic reviews, meta-analyses, and randomized controlled trials published from 2015-2023. Outcomes of interest included quality of life (QOL), patient satisfaction, physical and psychological symptoms, survival, and caregiver burden. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 52 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations address the integration of palliative care in oncology. Oncology clinicians should refer patients with advanced solid tumors and hematologic malignancies to specialized interdisciplinary palliative care teams that provide outpatient and inpatient care beginning early in the course of the disease, alongside active treatment of their cancer. For patients with cancer with unaddressed physical, psychosocial, or spiritual distress, cancer care programs should provide dedicated specialist palliative care services complementing existing or emerging supportive care interventions. Oncology clinicians from across the interdisciplinary cancer care team may refer the caregivers (eg, family, chosen family, and friends) of patients with cancer to palliative care teams for additional support. The Expert Panel suggests early palliative care involvement, especially for patients with uncontrolled symptoms and QOL concerns. Clinicians caring for patients with solid tumors on phase I cancer trials may also refer them to specialist palliative care.Additional information is available at www.asco.org/supportive-care-guidelines.
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Affiliation(s)
| | - Sarah Temin
- American Society of Clinical Oncology (ASCO), Alexandria, VA
| | - Arun Ghoshal
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Erin R Alesi
- Virginia Commonwealth University Health System, Massey Cancer Center, Richmond, VA
| | | | | | - James F Cleary
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | | | | | | | | | | | | | | | - Michael W Rabow
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
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Desmet L, Dezutter J, Vandenhoeck A, Dillen A. Healthcare Chaplaincy for Geriatric Patients: A Quasi-Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium. JOURNAL OF RELIGION AND HEALTH 2024; 63:1985-2010. [PMID: 38240943 PMCID: PMC11061025 DOI: 10.1007/s10943-023-01982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 05/02/2024]
Abstract
The present non-randomized clinical trial examined the short-term outcomes of one-on-one chaplaincy interventions with 416 geriatric patients in Belgium. Participants were interviewed one or two days before a potential chaplaincy intervention (baseline measurement), and one or two days after a potential intervention (post-measurement). Patients in the non-randomized intervention group received an intervention by the chaplain, while the non-randomized comparison group did not. Patients in the intervention group showed a significant decrease in state anxiety and negative affect, and a significant improvement in levels of hope, positive affect, peace, and Scottish PROM-scores, compared to the comparison group. Levels of meaning in life and faith did not significantly change after the chaplaincy intervention. This study suggests that geriatric patients may benefit from chaplaincy care and recommends the integration of chaplaincy care into the care for older adults.
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Affiliation(s)
- Lindsy Desmet
- Faculty of Theology and Religious Studies, KU Leuven, Sint-Michielsstraat 6, 3000, Leuven, Belgium.
| | - Jessie Dezutter
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Anne Vandenhoeck
- Faculty of Theology and Religious Studies, KU Leuven, Sint-Michielsstraat 6, 3000, Leuven, Belgium
| | - Annemie Dillen
- Faculty of Theology and Religious Studies, KU Leuven, Sint-Michielsstraat 6, 3000, Leuven, Belgium
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Tabaei-Aghdaei Z, McColl-Kennedy JR, Coote LV. Goal Setting and Health-Related Outcomes in Chronic Diseases: A Systematic Review and Meta-Analysis of the Literature From 2000 to 2020. Med Care Res Rev 2023; 80:145-164. [PMID: 35904147 DOI: 10.1177/10775587221113228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Identifying and synthesizing recent empirical research on goal setting among adults with chronic disease is the focus of this article. The article has two phases: Phase 1, a thematic analysis with machine reading of the data and manual thematic analysis, and Phase 2, a quantitative meta-analysis. Qualitative, quantitative, and mixed-method studies are included in Phase 1 (99 papers). Phase 2 includes only quantitative studies (75 papers). Five main themes are identified: (a) the effect of goal characteristics on health-related outcomes, (b) the effect of goal setting on health-related outcomes, (c) the effect of goal achievement on health-related outcomes, (d) goal alignment between patients and health care service providers, and (e) individual and collaborative goal setting of patients and health care service providers. The meta-analysis reveals considerable evidence of an association between goal setting and health-related outcomes.
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Buelens E, Dewitte L, Dezutter J, Vandenhoeck A, Dillen A. The outcomes of healthcare chaplaincy on hospitalized patients. A quasi-experimental study in Belgium. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2023. [DOI: 10.1080/19349637.2023.2177239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Eva Buelens
- Faculty of Theology and Religious Studies, University of Leuven, Leuven, Belgium
| | - Laura Dewitte
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Jessie Dezutter
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Anna Vandenhoeck
- Faculty of Theology and Religious Studies, University of Leuven, Leuven, Belgium
| | - Annemie Dillen
- Faculty of Theology and Religious Studies, University of Leuven, Leuven, Belgium
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8
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Wierstra IR, Liefbroer AI, Post L, Tromp T, Körver J. Addressing spiritual needs in palliative care: proposal for a narrative and interfaith spiritual care intervention for chaplaincy. J Health Care Chaplain 2023; 29:64-77. [PMID: 34923933 DOI: 10.1080/08854726.2021.2015055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Although many recognize the importance of addressing the spiritual domain in palliative care, empirically grounded interventions designed to alleviate spiritual needs for patients in palliative care are remarkably scarce. In this paper we argue that the development of such interventions for chaplains is important in order to improve spiritual care in a (post)secular and religiously plural context. We therefore propose an interfaith chaplain-led spiritual care intervention for home-based palliative care that addresses patients' spiritual needs. The intervention is based on elements of spiritual care interventions that have been investigated among other populations. Three important characteristics of the proposed intervention are (1) life review; (2) materiality, ritual and embodiment; and (3) imagination. The aim of this intervention is to improve palliative patients' spiritual wellbeing. It is anticipated that such a structured intervention could assist in improving spiritual care in palliative care.
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Affiliation(s)
- Iris R Wierstra
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Utrecht, The Netherlands.,Chair group Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands
| | - Anke I Liefbroer
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Utrecht, The Netherlands.,Faculty of Religion and Theology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lenneke Post
- Faculty of Religion and Theology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Spiritual Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thijs Tromp
- Department of Practical Theology, Protestant Theological University, Amsterdam, The Netherlands
| | - Jacques Körver
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Utrecht, The Netherlands.,University Center for Chaplaincy Studies, Utrecht, The Netherlands
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9
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Damen A, Visser A, van HWM, Leget C, Raijmakers N, van J, Fitchett G. Validation of the FACIT-Sp-12 in a Dutch cohort of patients with advanced cancer. Psychooncology 2021; 30:1930-1938. [PMID: 34258819 DOI: 10.1002/pon.5765] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Although the Dutch Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale (FACIT-Sp-12) has been used in several Dutch studies, no study has assessed the measurement properties of the translation. The aim of this study was to perform an item-reduction analysis, confirmatory factor analysis (CFA), test of reliability, and test of convergent validity. METHODS From the baseline data of a cohort study on experienced quality of care and quality of life (eQuiPe study), 400 advanced cancer patients without missing values on any of the variables were selected. In addition to demographic and religious/spiritual characteristics, study measures included the FACIT-Sp-12 and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30). RESULTS Item reduction analysis showed that Items 4 and 8 had low correlations to the total scale (<0.30). Items 6 and 7, and Items 9, 10, and 11 were highly correlated (>0.75). CFA indicated a good fit for a three-factor structure with Meaning, Peace and Faith, and good Cronbach's α coefficients for the total as well as the subscales (0.71-0.86). The removal of Items 4, 8, and 12 further improved the goodness of fit and Cronbach's α coefficients. Convergent validity was adequate with the EORTC-QLQ-C30. CONCLUSION Our analysis of the FACIT-Sp-12 revealed serious questions about three items and concerns about the Faith subscale. These problematic items deserve further attention so should be interpreted with care when using this scale. A future study could look into the items and test possible replacements.
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Affiliation(s)
- Annelieke Damen
- Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Anja Visser
- Faculty of Theology and Religious Studies, University of Groningen, Groningen, The Netherlands
| | - Hanneke W M van
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Carlo Leget
- Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Natasja Raijmakers
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Janneke van
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, Illinois, USA
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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