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Cancer patients, at both early and advanced stages, face complex bio-psycho-social-spiritual problems impacting their quality of life (QoL). Managing Cancer and Living Meaningfully (CALM) therapy is a psychotherapeutic approach that helps cancer patients find hope and meaning in life, thereby improving QoL.
This study aimed to critically assess the effects of CALM therapy on the QoL in cancer patients.
This was a systematic review and meta-analysis of randomised controlled trials (RCTs).
The main outcome was QoL, and the secondary outcomes were anxiety, depression, spiritual well-being, fatigue and sleep quality. Five English databases (PubMed, Embase, Scopus, Cochrane Library and ProQuest) and one trial registry site (Clinicaltrial.gov) were searched from their inception until March 2024. The pooled effect sizes were calculated using random-effects models and expressed as standard mean difference (SMD) or weighted mean difference (WMD). Review Manager 5.4 was used for data analysis. A sensitivity analysis was done by excluding one trial at a time to check the consistency of the results on QoL. The study protocol was prospectively registered on PROSPERO (CRD42023398655).
Fifteen trials met the inclusion criteria for the systematic review and twelve for the meta-analysis, with a total of 1635 cancer patients. CALM therapy showed significant benefits on QoL (SMD = 1.97), spiritual well-being (WMD = 1.93) and sleep quality (SMD = −1.56) compared with usual care. It also reduced anxiety (SMD = −1.94), depression (SMD = −1.28) and fatigue (SMD = −5.86) significantly. The sensitivity analysis confirmed the stability of these results when each trial was removed one by one.
CALM therapy may improve QoL, spiritual well-being, sleep quality and relieve anxiety, depression and fatigue in cancer patients.
This therapy should be promoted clinically as a comprehensive psychotherapeutic approach in cancer care.
CRD42023398655.
This study aimed to review studies exploring the experiences and perceptions of healthcare students and providers regarding their personal choices for elective female fertility preservation and their recommendations of the same to patients.
Employing Pluye and Hong's convergent qualitative synthesis approach, a mixed-studies review was conducted. The appraisal of studies was performed using the Mixed Methods Appraisal Tool and data analysis utilised Thomas and Harden's thematic synthesis approach.
Six electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus and Web of Science) were searched from their inception till November 2023.
About 24 studies were reviewed, uncovering four major themes: varied personal perspectives, knowledge gaps and role ambiguities, perceived temporal and financial constraints and apprehensions related to fear and stigma.
This review underscored the challenges faced by healthcare professionals and students in their personal pursuit of elective fertility preservation. Addressing these challenges demands the implementation of fertility navigators, culturally and religiously sensitive public health campaigns and staff training. Moreover, standardised guidelines, transparent cost and process reporting, evidence-based education, counselling on risks and success rates and governmental support in the form of subsidies can mitigate barriers, enhance cost-effectiveness and promote equitable access to care. Collaboration among stakeholders is imperative to ensure equitable access and maintain quality care in elective female fertility preservation.
This mixed studies review followed the reporting guidelines in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement.
No Patient or Public Contribution.
Trial Registration: This review has been registered on the Prospective Register of Systematic Reviews (PROSPERO) database (CRD42023395406)
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