Interventions to enhance self‐efficacy in cancer patients: A meta‐analysis of randomized controlled trials
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Self-management interventions improve physical and psychosocial health, health behaviors, and healthcare resource use in chronic illnesses and cancer.
“randomized trials in chronic illnesses and cancer suggest that interventions that promote self-management are effective in improving physical and psychosocial health, health behaviors, and healthcare resource use (ER visits, at home nursing care, readmissions) [12, 13].”
From Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers (2020) · cites this paper as [12]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Ryan, R. M., & Deci, E. L. (2000) · American Psychologist · doi:10.1037//0003-066x.55.1.68 · Cited by 27,815 · see citing works
The benefits of being present: Mindfulness and its role in psychological well-being
Brown, K. W., & Ryan, R. M. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.84.4.822 · Cited by 13,448 · see citing works
Distribution Theory for Glass's Estimator of Effect Size and Related Estimators
Hedges, L. V. (1981) · Journal of Educational Statistics · doi:10.2307/1164588 · Cited by 5,695 · see citing works
On the Self-Regulation of Behavior
Carver, C. S., & Scheier, M. F. (1998) · Cambridge University Press eBooks · doi:10.1017/cbo9781139174794 · Cited by 4,110 · see citing works
Robust variance estimation in meta‐regression with dependent effect size estimates
Hedges, L. V., Tipton, E., & Johnson, M. C. (2010) · Research Synthesis Methods · doi:10.1002/jrsm.5 · Cited by 2,086 · see citing works
Basics of meta‐analysis: <i>I</i> <sup>2</sup> is not an absolute measure of heterogeneity
Borenstein, M., Higgins, J. P. T., Hedges, L. V., & Rothstein, H. R. (2017) · Research Synthesis Methods · doi:10.1002/jrsm.1230 · Cited by 1,848 · see citing works
Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis
Everdingen, M. H. J. V. D. B.-V., Hochstenbach, L. M. J., Joosten, E. A. J., Tjan‐Heijnen, V. C. G., & Janssen, D. J. A. (2016) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2015.12.340 · Cited by 1,671 · see citing works
Mohr, D. C., Cuijpers, P., & Lehman, K. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1602 · Cited by 1,097 · see citing works
Sheeran, P., Maki, A., Montanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W. M. P., Miles, E., & Rothman, A. J. (2016) · Health Psychology · doi:10.1037/hea0000387 · Cited by 1,085 · see citing works
Mustian, K. M., Alfano, C. M., Heckler, C., Kleckner, A. S., Kleckner, I. R., Leach, C. R., Mohr, D., Palesh, O. G., Peppone, L. J., Piper, B. F., et al. (2017) · JAMA Oncology · doi:10.1001/jamaoncol.2016.6914 · Cited by 932 · see citing works
Small sample adjustments for robust variance estimation with meta-regression.
Tipton, E. (2015) · Psychological Methods · doi:10.1037/met0000011 · Cited by 810 · see citing works
It's Not over When it's Over: Long-Term Symptoms in Cancer Survivors—A Systematic Review
Harrington, C. B., Hansen, J. A., Moskowitz, M. C., Todd, B. L., & Feuerstein, M. (2010) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.40.2.c · Cited by 655 · see citing works
Optimal search strategies for retrieving systematic reviews from Medline: analytical survey
Montori, V. M., Wilczynski, N. L., Morgan, D., & Haynes, R. B. (2005) · BMJ · doi:10.1136/bmj.38336.804167.47 · Cited by 422 · see citing works
Hilfiker, R., Meichtry, A., Eicher, M., Nilsson Balfe, L., Knols, R. H., Verra, M. L., & Taeymans, J. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096422 · Cited by 396 · see citing works
Tipton, E., & Pustejovsky, J. E. (2015) · Journal of Educational and Behavioral Statistics · doi:10.3102/1076998615606099 · Cited by 362 · see citing works
Self-citationTesting for funnel plot asymmetry of standardized mean differences
Pustejovsky, J. E., & Rodgers, M. A. (2019) · Research Synthesis Methods · doi:10.1002/jrsm.1332 · Cited by 354 · see citing works
Self-citationLinde, J. A., Rothman, A. J., Baldwin, A. S., & Jeffery, R. W. (2006) · Health Psychology · doi:10.1037/0278-6133.25.3.282 · Cited by 307 · see citing works
Meta-Analysis of Psychosocial Interventions to Reduce Pain in Patients With Cancer
Sheinfeld Gorin, S., Krebs, P., Badr, H., Janke, E. A., Jim, H. S. L., Spring, B., Mohr, D. C., Berendsen, M. A., & Jacobsen, P. B. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.37.0437 · Cited by 292 · cited 3× · see citing works
“34).(4) Importantly, these results occur in the context of studies that were screened for high quality, where there was low risk of bias and no apparent small‐study bias.”
BackgroundResultInfluentialSelf-citationTelch, C. F., & Telch, M. J. (1986) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.54.6.802 · Cited by 290 · see citing works
Foster, C. L., Wright, D. N. M., HILL, H., Hopkinson, J. B., & Roffe, L. (2009) · European Journal of Cancer Care · doi:10.1111/j.1365-2354.2008.01001.x · Cited by 245 · see citing works
Graves, K. D. (2003) · Health Psychology · doi:10.1037/0278-6133.22.2.210 · Cited by 239 · see citing works
Taylor, C. T., Lyubomirsky, S., & Stein, M. B. (2017) · Depression and Anxiety · doi:10.1002/da.22593 · Cited by 233 · see citing works
Self‐efficacy for coping with cancer: revision of the Cancer Behavior Inventory (version 2.0)
Merluzzi, T. V., Nairn, R. C., Hegde, K., Sanchez, M. A. M., & Dunn, L. (2001) · Psycho-Oncology · doi:10.1002/pon.511 · Cited by 227 · see citing works
Self-citationChirico, A., Lucidi, F., Merluzzi, T. V., Alivernini, F., Laurentiis, M. D., Botti, G., & Giordano, A. (2017) · Oncotarget · doi:10.18632/oncotarget.15758 · Cited by 221 · see citing works
Self-citationJones, F., Partridge, C. J., & Reid, F. (2008) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2008.02333.x · Cited by 218 · see citing works
Hart, S. L., Hoyt, M., Diefenbach, M., Anderson, D. R., Kilbourn, K., Craft, L., Steel, J., Cuijpers, P., Mohr, D., Berendsen, M., et al. (2012) · Journal of the National Cancer Institute · doi:10.1093/jnci/djs256 · Cited by 217 · see citing works
Self-citationLipsett, A., Barrett, S., Haruna, F., Mustian, K. M., & O’Donovan, A. (2017) · The Breast · doi:10.1016/j.breast.2017.02.002 · Cited by 217 · see citing works
van de Wal, M., Thewes, B., Gielissen, M., Speckens, A., & Prins, J. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.70.5301 · Cited by 195 · see citing works
Higgins, J. P., Ramsay, C., Reeves, B. C., Deeks, J. J., Shea, B., Valentine, J. C., Tugwell, P., & Wells, G. (2013) · Research Synthesis Methods · doi:10.1002/jrsm.1056 · Cited by 183 · see citing works
Richter, D., Koehler, M., Friedrich, M., Hilgendorf, I., Mehnert, A., & Weißflog, G. (2015) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2015.04.003 · Cited by 146 · see citing works
Pai, A. L. H., Drotar, D., Zebracki, K., Moore, M. E., & Youngstrom, E. A. (2006) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsj109 · Cited by 142 · see citing works
Dieng, M., Butow, P. N., Costa, D. S. J., Morton, R. L., Menzies, S. W., Mireskandari, S., Tesson, S., Mann, G. J., Cust, A. E., & Kasparian, N. A. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2016.68.2278 · Cited by 123 · see citing works
Depression and cancer survivorship: importance of coping self‐efficacy in post‐treatment survivors
Philip, E. J., Merluzzi, T. V., Zhang, Z. J., & Heitzmann, C. A. (2012) · Psycho-Oncology · doi:10.1002/pon.3088 · Cited by 116 · see citing works
Self-citationSelf-efficacy as a health-protective resource in teachers? A biopsychological approach.
Schwerdtfeger, A. R., Konermann, L., & Schonhofen, K. (2008) · Health Psychology · doi:10.1037/0278-6133.27.3.358 · Cited by 111 · see citing works
Eady, A., Wilczynski, N. L., & Haynes, R. B. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.09.016 · Cited by 97 · see citing works
Adult attachment variables predict depression before and after treatment for chronic pain
Meredith, P. J., Strong, J., & Feeney, J. A. (2006) · European Journal of Pain · doi:10.1016/j.ejpain.2006.01.004 · Cited by 89 · see citing works
Optimal CINAHL Search Strategies for Identifying Therapy Studies and Review Articles
Wong, S. S.-L., Wilczynski, N. L., & Haynes, R. B. (2006) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.2006.00100.x · Cited by 85 · see citing works
Moyer, A. E., Sohl, S. J., Knapp‐Oliver, S. K., & Schneider, S. (2009) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2009.02.003 · Cited by 84 · see citing works
Self-citationMerluzzi, T. V., Philip, E. J., Yang, M., & Heitzmann, C. A. (2015) · Psycho-Oncology · doi:10.1002/pon.3896 · Cited by 67 · see citing works
Self-citationSelf-efficacy for coping with cancer: Revision of the Cancer Behavior Inventory (Version 3.0).
Merluzzi, T. V., Philip, E. J., Heitzmann, C. A., Liu, H., Yang, M., & Conley, C. C. (2017) · Psychological Assessment · doi:10.1037/pas0000483 · Cited by 60 · see citing works
Self-citationMishra, S. I., Scherer, R. W., Snyder, C. F., Geigle, P. M., & Gotay, C. C. (2014) · Oncology nursing forum · doi:10.1188/15.onf.e33-e53 · Cited by 57 · see citing works
Royle, P., & Waugh, N. R. (2005) · BMC Medical Research Methodology · doi:10.1186/1471-2288-5-23 · Cited by 55 · see citing works
Liang, S., Chao, T., Tseng, L., et al. (2015) · Cancer Nursing · doi:10.1097/ncc.0000000000000244 · Cited by 52 · see citing works
Rahman, A., Reed, E., Underwood, M. R., Shipley, M. E., & Omar, R. (2008) · Lara D. Veeken · doi:10.1093/rheumatology/ken377 · Cited by 50 · see citing works
Marszalek, J., Price, L. L., Harvey, W. F., Driban, J. B., & Wang, C. (2016) · Arthritis Care & Research · doi:10.1002/acr.22969 · Cited by 37 · see citing works
Health and personal resources in older patients with cancer undergoing chemotherapy
Robb, C., Lee, A., Jacobsen, P. B., Dobbin, K. K., & Extermann, M. (2013) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2012.12.002 · Cited by 29 · see citing works
The prevalence of psychological distress by cancer site
Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001) · Psycho-Oncology · doi:10.1002/1099-1611(200101/02)10:1
Flagged first, then by citations
Research works printed but not linked: 5
- [33]Haynes RB, McKibbon KA, Wilczynski NL, Walter SD, Werre SR. Optimal search strategies for retrieving scientifically strong studies of treatment from Medline: analytical survey. British Medical Journal 2005; 330(7051): 1179. 15894554 PMC558012
- [41]Tukey J Exploratory Data Analysis Boston: Addison-Wesley; 1977.
- [42]Lipsey MW, Wilson DB. Practical Meta-analysis Thousand Oaks CA: Sage Publications; 2001.
- [49]Viechtbauer W Conducting meta-analysis in R with metafor package. Journal of Statistical Software 2010; 36(3): 1– 48.
- [54][dataset] Merluzzi TV, Pustejovsky JE, Philip EJ, Sohl SJ, Berendsen MA, & Salaman JS; March 14, 2019; Self-efficacy data.csv; CurateND; Link: https://curate.nd.edu/show/jw827943c2d. PMC6731146 31206917
Cited by
Sorted by citations
Lafaro, K. J., Raz, D. J., Kim, J. Y., Hite, S., Ruel, N., Varatkar, G., Erhunmwunsee, L., Melstrom, L., Lee, B., Singh, G., et al. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-019-05230-0 · Cited by 64 · see citing works
Chu, Q., Wong, C. C. Y., Chen, L., Shin, L. J., Chen, L., & Lu, Q. (2021) · Psycho-Oncology · doi:10.1002/pon.5590 · Cited by 33 · see citing works
“For example, cognitive– behavioral therapy has shown promise for reducing cancer survivors' concerns and improving self‐efficacy.(37,38) In addition, healthcare providers may devote more time to inquiring about survivors' con-”
Background
- Authors
- Merluzzi, T. V., Pustejovsky, J. E., Philip, E. J., Sohl, S. J., Berendsen, M., & Salsman, J. M.
- Affiliations
- University of Notre Dame (US)
- The University of Texas at Austin (US)
- Wake Forest University (US)
- Northwestern University (US)
- Corresponding author
- Merluzzi, Thomas V.
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2019-07-09
- Volume
- 28
- Issue
- 9
- Pages
- 1781-1790
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC6731146
- OpenAlex
- W2951606584
- Cited by
- 122
- References
- 47
- Citations by year
- 2026: 20 · 2025: 22 · 2024: 30 · 2023: 14 · 2022: 19 · 2021: 10 · 2020: 5 · 2019: 2
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R03CA184560)
- National Center for Complementary and Integrative Health (K01AT008219)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- self-efficacy, cancer patients, psychological intervention, health behavior, social learning theory, emotional distress, fatigue, pain, intervention delivery format
- MeSH terms
- Humans, Neoplasms, Psychotherapy, Randomized Controlled Trials as Topic, Self Efficacy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
