Interventions strategies and their efficacy in illness perceptions in patients with cancer: A systematic review and meta-analysis

Purpose s: To identify intervention strategies for improving illness perception (IP) of cancer patients and/or family caregivers; and to examine the effects of IP interventions by meta-analysis. Methods A systematic search was performed to identify literature that focused on improving the IP of cancer patients and/or family caregivers from the establishment of eight databases to August 2023. Manual screening was also applied. The IP intervention strategies for cancer populations were synthesized basing the CSM. Meta-analysis was conducted to assess the effects of IP interventions on health outcomes. Multiple subgroup analyses of the same intervention conditions were conducted to explore the optimal IP-focused intervention. Results 18 studies were included. 11 studies were conducted in a meta-analysis. No studies on family caregivers' IP were identified. Compared to general care, subgroup analysis revealed that IP interventions had favorable effects on cancer patients' IP as well as quality of life and other outcomes. Six IP intervention strategies (information support, cognitive reframing, emotion adjustment, active coping, effective appraisal, and self-social identification) were generated. Meta-analysis showed that compared with theory-less studies (Z= 8.64, p <0.01) and single delivery formats (Z= 3.66, p <0.01), the theory-based interventions (Z= 10.86, p <0.01) and mixed delivery formats (Z= 7.15, p <0.01) had higher positive effects on IP outcomes. Conclusions The positive outcomes of IP intervention focusing on cancer patients were highlighted. IP traits and patients' and their caregivers' needs in coping with specific cancer types should be explored before the intervention design. More IP interventions targeting cancer dyads are warranted to develop in the future.