Effectiveness of Managing Cancer and Living Meaningfully Therapy on Health-Related Outcomes for Patients With Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Yizhen Zhang, Xu Zhang, Xiaoming Zhang and 2 others
PMID 40290084WHAT IT FOUND
CALM therapy lowered psychological distress, anxiety and depression and improved quality of life in cancer patients.
It did not clearly reduce fear of recurrence. Evidence was low certainty.
Key findings
01In 11 RCTs with 1284 cancer patients, CALM was delivered in three to six sessions spanning 3 to 8 months, each 30 to 70 minutes, and it reduced psychological distress (MD = −2.43, 95% CI −3.99 to −0.86), anxiety (SMD = −1.06, 95% CI −1.78 to −0.34), depression (SMD = −0.65, 95% CI −1.13 to −0.17), and improved quality of life (SMD = 1.44, 95% CI 0.47 to 2.40).
02CALM therapy also reduced cancer-related fatigue (SMD = −3.54, 95% CI −5.84 to −1.23) and improved sleep disturbance (SMD = −1.00, 95% CI −1.86 to −0.14), but did not significantly reduce fear of cancer recurrence (SMD = −2.06, 95% CI −4.59 to 0.47).
03At 1-month follow-up, quality of life was not significantly improved (SMD = 1.39, 95% CI −0.04 to 2.83), and the overall certainty of evidence was low.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included trials had high risk of bias because participants and intervention providers were often not blinded. The pooled results showed high heterogeneity, so the average effect may not apply to any one patient group. Most studies were conducted in China, so cultural generalizability is uncertain. Follow-up was short, so long-term effects were not confirmed. Some outcomes were based on few studies. The review did not examine effects by specific cancer type. GRADE rated the certainty of evidence as low.
The easy way to misread this
Do not conclude that CALM therapy is proven to reduce fear of cancer recurrence or to have lasting quality-of-life benefit. The fear-of-recurrence result was null, the quality-of-life benefit was not significant at follow-up, and the evidence was low certainty with high heterogeneity.