Effects of CBT-based interventions on health outcomes in breast cancer patients: a systematic review and Meta-analysis.

PURPOSE

The systematic review and meta-analysis aimed to comprehensively evaluate the impact of cognitive-behavioral therapy (CBT)-based interventions on health outcomes in patients with breast cancer. Additionally, it assessed the implementation and sustainability of these interventions in clinical and healthcare settings.

METHODS

A search of electronic databases including PubMed, Web of Science, Cochrane Library, CINAHL, CNKI, and Wanfang Data Knowledge Service Platform was conducted for relevant studies published between July 2014 and July 2024. Standardized Mean Differences (SMD) with 95% Confidence Intervals (CIs) were used to determine the effects of the interventions. The pooled effect size was calculated using a random-effects model. The RE-AIM Framework was used to evaluate the potential implementation and sustainability of the interventions in real-world settings.

RESULTS

This systematic review incorporated 14 randomized controlled trials and quasi-experimental studies. We found that various CBT-based interventions had positive effects on fear of cancer recurrence (SMD = - 0.64; 95% CI [- 1.02, - 0.26]; P = 0.0011), anxiety (SMD = - 0.38; 95% CI [- 0.65, - 0.10]; P = 0.0068), depression (SMD = - 0.49; 95% CI [- 0.80, - 0.19]; P = 0.0017), mindfulness skills (SMD = 0.80; 95% CI [0.48, 1.13]; P < 0.0001), fatigue (SMD = - 0.37; 95% CI [- 0.59, - 0.15]; P = 0.0011), quality of life (SMD = 0.54; 95% CI [0.14, 0.93]; P = 0.0080), sleep (SMD = - 0.16; 95% CI [- 0.32, - 0.01]; P = 0.0398), positive psychology (SMD = 2.19; 95% CI [0.38, 4.00]; P = 0.0178) and spiritual well-being (SMD = 0.89; 95% CI [0.56, 1.21]; P < 0.0001). However, there was no significant effect on perceived stress in patients with breast cancer (SMD = - 0.70; 95% CI [- 1.44, 0.04]; P = 0.0634).

CONCLUSIONS

CBT-based interventions are effective in improving the health outcomes of patients with breast cancer. Rigorously designed randomized controlled trials are needed to validate CBT-based interventions (such as personalized, long-term, and diversified intervention strategies) to optimize psychological health interventions and enhance health outcomes for these patients.