A Meta-Analysis of Intervention Research for Posttraumatic Growth in Cancer Patients

Mi Hyang Park; Jeong Sook Park

doi:10.5388/aon.2016.16.1.9

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Park and Park: A Meta-Analysis of Intervention Research for Posttraumatic Growth in Cancer Patients

Review Article

Asian Oncology Nursing 2016; 16(1): 9-19.

Published online: 31 March 2016

DOI: https://doi.org/10.5388/aon.2016.16.1.9

A Meta-Analysis of Intervention Research for Posttraumatic Growth in Cancer Patients

Mi Hyang Park¹, Jeong Sook Park²

¹College of Nursing, Yeungnam University, Daegu, Korea.

²College of Nursing, Keimyung University, Daegu, Korea.

Address reprint requests to: Park, Jeong Sook. College of Nursing, Keimyung University of Korea, 2800 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3904, jsp544@kmu.ac.kr

Received 18 January 2016 Revised 8 March 2016 Accepted 26 March 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The objective of this study was to analyze effect size of the intervention studies for posttraumatic growth in patients with cancer.

Methods

A total of 871 studies published between 2000 and 2014 were identified by searching Ovid-Medline, CINAHL, PubMed, Scopus, PsycARTICLES, Cochrane library, RISS, and KISS. 15 studies were selected for inclusion in the meta-analysis. Data were analyzed using the Comprehensive Meta-Analysis (CMA) Ver. 3 program and the effect sizes were shown using Hedges's g score.

Results

Intervention studies included 5 studies on Cognitive Behavioral Stress Management (CBSM), 4 studies for Mindfulness-Based Stress Reduction (MBSR), 2 studies for couple-based intervention, and 1 study each for health coaching, building resilience, yoga and painting intervention. The overall controlled effect size was 0.335 (95% CI=0.231, 0.438), using a fixed effects model. The most effective intervention was the couple-based intervention (0.368, 95% CI=-0.146, 0.883), followed by MBSR (0.340, 95% CI=0.172, 0.508) and CBSM (0.314, 95% CI=0.139, 0.490).

Conclusion

Cancer is one of the most significant traumatic events that affect patients' lives, a few cancer patients have been known to have posttraumatic growth. Therefore it is necessary to consider nursing interventions to increase posttraumatic growth for cancer patients such as couple-based intervention, MBSR and CBSM.

Keywords: Neoplasms, Growth, Meta-Analysis, Clinical Trial

Figures and Tables

Fig. 1

Flow Studies included from Database Search.

Fig. 2

Effect Size of Interventions on Cancer-related PTG.

Fig. 3

Effect Size of CBSM, MBSR and Couple Intervention on Cancer-related PTG.

Table 1

General Characteristics of Included Study (N=15)

Characteristics	Categories	n (%)
Published year	2000~2005	3 (20.0)
	2006~2010	4 (26.7)
	2011~2015	8 (53.3)
Publication status	Dissertation	2 (13.3)
Publication status	Journal	13 (86.7)
Nation	U.S.A	8 (53.3)
	Republic of Korea	2 (13.3)
	Germany	2 (13.3)
	Australia	1 (6.7)
	Canada	1 (6.7)
	Israel	1 (6.7)
Field of study	Psychology	10 (66.6)
	Medicine	3 (20)
	Nursing	1 (6.7)
	Public health	1 (6.7)
Study design	Randomized controlled trial	12 (80.0)
Study design	Non randomized controlled trial	3 (20.0)
IRB	Described	10 (66.7)
IRB	Not described	5 (33.3)
Criteria for sample size decision	Described	4 (26.7)
Criteria for sample size decision	Not described	11 (73.3)
Participants	Experimental group	820 (49.2)
Participants	Control group	846 (50.8)
Measurement	PTGI	8 (53.3)
	BFS	6 (40.0)
	SRGS	1 (6.7)
Type of cancer	Breast cancer	8 (53.2)
	Breast cancer and gynecological cancer	1 (6.7)
	Colorectal cancer	1 (6.7)
	Prostate cancer	1 (6.7)
	Haemagological cancer	1 (6.7)
	Any type of cancer	3 (20.0)

IRB=Institutional review board; PTGI=Posttraumatic growth inven-tory; BFS=Benefit finding scale; SRGS=Stress related growth scale.

Table 2

Characteristics of PTG Intervention for Cancer Patients (N=15)

Author (year)	Location	Type of cancer	Study design	Participants		Intervention				Measurements
Author (year)	Location	Type of cancer	Study design	Exp. (n)	Cont. (n)	Type of intervention	Time per 1 session (min)	Number of session	Period (weeks)	Measurements
Yun MR (2014)	Korea	Breast cancer	RCT	22	24	MBSR	120	16	8	PTGI
Heinrichs N et al. (2012)	Germany	Breast or gynecological cancer	RCT	17	14	Couple-based intervention	120	8	4	PTGI
Yun YH et al. (2013)	Korea	Any type of cancer	RCT	34	36	Health partner training program	-	-	8	PTGI
Hawkes AL et al. (2014)	Australia	Colorectal Cancer	RCT	149	155	MBSR	-	11	Over	PTGI
Hawkes AL et al. (2014)	Australia	Colorectal Cancer	RCT	149	155	MBSR	-	11	6-month	PTGI
Zernicke KA et al. (2014)	U.S.A.	Any type of cancer	RCT	30	32	MBCR (MBSR)	120	8	8	PTGI
Pat-Horenczyk R et al. (2015)	Israel	Breast cancer	NRCT	49	45	Building resilience intervention	90	8	8	PTGI
Labelle LE et al. (2015)	Canada	Any type of cancer	NRCT	75	61	MBSR	90	9	8	PTGI
Wiesenthal NL (2006)	U.S.A.	Breast cancer	RCT	16	10	Couple-based intervention	75	6	6	PTGI
Penedo FK et al. (2006)	U.S.A.	Prostate cancer	RCT	105	86	CBSM	120	10	10	BFS
Antoni MH et al. (2001)	U.S.A.	Breast cancer	RCT	47	53	CBSM	120	10	10	BFS
Antoni MH et al. (2006)	U.S.A.	Breast cancer	RCT	74	83	CBSM	120	10	10	BFS
McGregor BA et al. (2004)	U.S.A.	Breast cancer	RCT	18	11	CBSM	120	10	10	BFS
Chandwani KD et al. (2010)	U.S.A.	Breast cancer	RCT	27	29	Yoga	60	6~12	6	BFS
Cruess DG et al. (2000)	U.S.A.	Breast cancer	RCT	24	10	CBSM	120	10	10	BFS
Singer S et al. (2012)	Germany	Haematological cancer	NRCT	36	129	Art education	90	22	22	SRGS

MBSR=Mindfulness-based stress reduction; MBCR=Mindfulness-based cancer recovery; CBSM=Cognitive-behavioral stress management; PTGI=Posttraumatic growth inventory; BFS=Benefit finding scale; SRGS=Strsee related growth scale; RCt=Randomized controlled trial; NRCt=Non randomized controlled trial.

Appendix

Appendix 1

Studies included in Meta-analysis

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