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

Authors

Tom V. Merluzzi

James E. Pustejovsky

Errol J. Philip

Stephanie J. Sohl

Mark Berendsen

John A. Salsman

Published

June 6, 2019

Journal Data

Objective: Self-efficacy expectations are associated with improvements in problematic outcomes widely considered clinically significant (i.e., emotional distress, fatigue, 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 selfefficacy expectations are positively related to future behaviors that promote health and wellbeing. 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: 1) an adult cancer sample, 2) a self-efficacy expectation measure of specific behaviors and 3) 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 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; e.g., audiovisual, print, telephone, web/internet).

Conclusions: The results establish the impact of psychological interventions on self-efficacy expectations as comparable in effect size to commonly reported outcomes (distress, fatigue, pain). Additionally, the result that in-person interventions achieved the largest effect is supported by Social Learning Theory and could inform research related to the development and evaluation of interventions.

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Citation

BibTeX citation:
@article{merluzzi2019,
  author = {Merluzzi, Tom V. and Pustejovsky, James E. and Philip, Errol
    J. and Sohl, Stephanie J. and Berendsen, Mark and Salsman, John A.},
  title = {Interventions to Enhance Self-Efficacy in Cancer Patients and
    Survivors: {A} Meta-Analysis of Randomized Controlled Trials},
  journal = {Psycho-Oncology},
  volume = {28},
  number = {9},
  pages = {1781-1790},
  date = {2019-06-06},
  url = {https://doi.org/10.1002/pon.5148},
  doi = {10.1016/j.jsp.2018.02.003},
  langid = {en}
}
For attribution, please cite this work as:
Merluzzi, T. V., Pustejovsky, J. E., Philip, E. J., Sohl, S. J., Berendsen, M., & Salsman, J. A. (2019). Interventions to enhance self-efficacy in cancer patients and survivors: A meta-analysis of randomized controlled trials. Psycho-Oncology, 28(9), 1781–1790. https://doi.org/10.1016/j.jsp.2018.02.003