Efficacy of resilience-related psychological interventions in patients with long-term diseases: A meta-analysis of randomised controlled trials

Fitria Endah Janitra; Ruey Chen; Hui-Chen Lin; Chien-Mei Sung; Hsin Chu; Chiu-Kuei Lee; Shu-Fen Niu; Hsin-I Liu; Li-Fang Chang; Kondwani Joseph Banda; Kuei-Ru Chou

doi:10.1111/inm.13334

Efficacy of resilience-related psychological interventions in patients with long-term diseases: A meta-analysis of randomised controlled trials

Int J Ment Health Nurs. 2024 Apr 23. doi: 10.1111/inm.13334. Online ahead of print.

Authors

Fitria Endah Janitra^{1

2}, Ruey Chen^{1

3

4}, Hui-Chen Lin^{1

5}, Chien-Mei Sung^{1

6}, Hsin Chu^{7

8}, Chiu-Kuei Lee^{1

3}, Shu-Fen Niu^{6

9}, Hsin-I Liu¹⁰, Li-Fang Chang^{1

11

12

13}, Kondwani Joseph Banda^{1

14}, Kuei-Ru Chou^{1

3

5

15

16}

Affiliations

¹ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
² Faculty of Nursing, Universitas Islam Sultan Agung, Semarang, Indonesia.
³ Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan.
⁴ Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
⁵ Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan.
⁶ Department of Nursing, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁷ Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
⁸ Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
⁹ Department of Nursing, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
¹⁰ Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
¹¹ Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan.
¹² School of Nursing, National Defense Medical Center, Taipei, Taiwan.
¹³ Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
¹⁴ Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi.
¹⁵ Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
¹⁶ Research Center for Neuroscience, Taipei Medical University, Taipei, Taiwan.

PMID: 38651215
DOI: 10.1111/inm.13334

Abstract

Patients with long-term disease experience low resilience, emphasising the importance of psychological interventions to improve resilience. However, there is no comprehensive evidence on the efficacy of resilience-related psychological interventions (RRPIs) in this population. Therefore, we performed a meta-analysis to evaluate and extend knowledge from previous meta-analyses on the efficacy of RRPIs on resilience, stress, anxiety, depression and quality of life among patients with long-term disease. Cochrane Library, Embase, Ovid-MEDLINE, PubMed, Scopus, Web of Science and CINAHL electronic databases were searched until 3 February 2023. The pooled effect size of the efficacy of RRPIs was calculated using the Hedges' g (g) with random-effects model, while Cochrane Q-statistics and I² tests assessed heterogeneity in Comprehensive Meta-Analysis 3.0 software. The Cochrane Risk of Bias 2.0 tool evaluated the quality of studies. Moderator analysis was used to explore sources of heterogeneity. Twenty randomised controlled trial studies were identified, representing a total of 1388 individuals with long-term disease. RRPIs significantly enhance resilience (g = 0.79), alleviate stress (g = -0.78), decrease anxiety (g = -1.14), mitigate depression (g = -0.96) and improve quality of life (g = 0.48). Positive psychology, mindfulness, cognitive behavioural therapy, acceptance and commitment-based intervention exhibited medium effects in strengthening resilience. Short-term effects of RRPIs on enhancing resilience were observed at 3-month follow-up period (g = 0.50). The incorporation of RRPIs into the management of patients with long-term disease shows a positive impact on their resilience, stress, anxiety, depression and quality of life. The results offer an evidence-based foundation for nurses in promoting resilience among patients with long-term disease.

Keywords: acceptance and commitment therapy; chronic disease; cognitive behavioural therapy; mindfulness; positive psychology; psychological intervention; resilience.