Interventions to enhance self-efficacy in cancer patients: A meta-analysis of randomized controlled trials

Thomas V. Merluzzi*, James E. Pustejovsky, Errol J. Philip, Stephanie J. Sohl, Mark Berendsen, John M. Salsman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations

Abstract

Objective: Self-efficacy expectations are associated with improvements in problematic outcomes widely considered clinically significant (ie, emotional distress, fatigue, and pain), related to positive health behaviors, and as a type of personal agency, inherently valuable. Self-efficacy expectancies, estimates of confidence to execute behaviors, are important in that changes in self-efficacy expectations are positively related to future behaviors that promote health and well-being. The current meta-analysis investigated the impact of psychological interventions on self-efficacy expectations for a variety of health behaviors among cancer patients. Methods: Ovid Medline, PsycINFO, CINAHL, EMBASE, Cochrane Library, and Web of Science were searched with specific search terms for identifying randomized controlled trials (RCTs) that focused on psychologically based interventions. Included studies had (a) an adult cancer sample, (b) a self-efficacy expectation measure of specific behaviors, and (c) an RCT design. Standard screening and reliability procedures were used for selecting and coding studies. Coding included theoretically informed moderator variables. Results: Across 79 RCTs, 223 effect sizes, and 8678 participants, the weighted average effect of self-efficacy expectations was estimated as g = 0.274 (P <.001). Consistent with the self-efficacy theory, the average effect for in-person intervention delivery (g = 0.329) was significantly greater than for all other formats (g = 0.154, P =.023; eg, audiovisual, print, telephone, and Web/internet). Conclusions: The results establish the impact of psychological interventions on self-efficacy expectations as comparable in effect size with commonly reported outcomes (distress, fatigue, pain). Additionally, the result that in-person interventions achieved the largest effect is supported by the social learning theory and could inform research related to the development and evaluation of interventions.

Original languageEnglish (US)
Pages (from-to)1781-1790
Number of pages10
JournalPsycho-oncology
Volume28
Issue number9
DOIs
StatePublished - Sep 1 2019

Funding

This research project was supported, in whole or in part, by the National Cancer Institute's Small Grants Program (Salsman: R03 CA184560) and the National Center for Complementary & Integrative Health (Sohl: K01AT008219). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank Carolyn A. Heitzmann Ruhf for her contributions.

Keywords

  • RCTs
  • cancer
  • intervention
  • meta-analysis
  • oncology
  • self-efficacy

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health

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