The Effectiveness of Positive Psychological Intervention Based on PERMA Model in Cancer Patients: A Systematic Review and Meta-Analysis

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-06-29 DOI:10.1111/jep.70175

Qin Wang, Qiuying Wu, Yanyan Wang, Tao Yang, Qiaoling Chen, Kaidi Yang

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引用次数: 0

Abstract

Background

Happiness is a fundamental goal for all individuals. However, cancer patients often find themselves at risk of happiness deprivation owing to the psychological and physical challenges posed by their condition.

Objectives

This systematic review aimed to evaluate the effectiveness of positive psychological interventions based on the PERMA model in enhancing happiness/well-being in cancer patients. A secondary objective was to assess their effects on anxiety, depression, fatigue, and fear of cancer recurrence.

Methods

A systematic review and meta-analysis were performed according to PRISMA guidelines. PubMed, EMBASE, CINAHL, Cochrane Library, PsycINFO, Scopus, and Web of Science databases were searched for experimental studies on PERMA-based positive psychological interventions for cancer patients (from inception to 15 May 2024). Two researchers independently performed data screening, extraction, and risk of bias assessments using Cochrane's Risk of Bias Tool (RoB 2). Meta-analysis techniques were applied, and evidence certainty was evaluated using the GRADE system.

Results

Fourteen studies involving 1200 cancer patients met the inclusion criteria, with thirteen included in the meta-analysis. PERMA model-based positive psychological interventions significantly improved happiness/well-being (standardized mean difference [SMD]: 1.19; 95% confidence interval [CI]: 0.68–1.70) and were associated with reductions in anxiety (MD: −2.98; 95% CI: −3.29 to −2.67), depression (MD: −2.08; 95% CI: −2.20 to −1.96), fatigue (MD: −2.14; 95% CI: −2.20 to −2.08) and fear of cancer recurrence (MD: −5.10; 95% CI: −6.27 to −3.94). The certainty of evidence for all outcomes was rated as low or very low.

Conclusions

This meta-analysis provides preliminary evidence that PERMA-based positive psychological interventions have the potential to enhance happiness/well-being in cancer patients while alleviating psychological distress. However, substantial heterogeneity and methodological limitations preclude definitive recommendations, highlighting the need for further high-quality research.

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基于PERMA模型的积极心理干预在癌症患者中的有效性：系统回顾和meta分析

幸福是所有人的基本目标。然而，由于癌症带来的心理和身体上的挑战，癌症患者经常发现自己有被剥夺幸福的风险。目的本系统综述旨在评估基于PERMA模型的积极心理干预在提高癌症患者幸福感方面的有效性。第二个目的是评估它们对焦虑、抑郁、疲劳和对癌症复发的恐惧的影响。方法根据PRISMA指南进行系统评价和meta分析。检索PubMed、EMBASE、CINAHL、Cochrane Library、PsycINFO、Scopus和Web of Science等数据库，检索从成立到2024年5月15日基于permaar的癌症患者积极心理干预的实验研究。两位研究者使用Cochrane风险偏倚工具（RoB 2）独立进行了数据筛选、提取和偏倚风险评估。采用荟萃分析技术，并使用GRADE系统评估证据的确定性。结果14项研究，涉及1200名癌症患者，符合纳入标准，其中13项纳入meta分析。基于PERMA模型的积极心理干预显著提高了幸福感(标准化平均差异[SMD]: 1.19；95%可信区间[CI]: 0.68-1.70)，并与焦虑减少相关(MD:−2.98；95% CI:−3.29 ~−2.67)，抑郁(MD:−2.08；95% CI:−2.20 ~−1.96)，疲劳(MD:−2.14；95% CI:−2.20 ~−2.08)和对癌症复发的恐惧(MD:−5.10；95% CI:−6.27 ~−3.94)。所有结果的证据确定性被评为低或非常低。结论本荟萃分析提供了初步证据，表明基于permaar的积极心理干预有可能提高癌症患者的幸福感，同时减轻心理困扰。然而，由于大量的异质性和方法上的局限性，无法提出明确的建议，因此需要进一步进行高质量的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.