Table 2.
Pooled Postintervention Effects of CBT on Resilience among Cancer Patients (N = 13)
| Effect | Sample size | Heterogeneity | Global Effect Size | Failsafe No.‡ | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| K | N | Q⇃ | df | P | I2 | Hedges’s ga | 95% CI | P | |||
| Overall combined effect | 13 | 1185 | 53.92 | 12 | < 0.001 | 77.7% | 1.211 | 0.933 | 1.490 | < 0.001 | 1141 |
| Gender: Mixed | 8 | 775 | 26.75 | 7 | 0.008 | 73.8% | 1.355 | 1.031 | 1.679 | < 0.001 | 559 |
| Gender: female | 4 | 290 | 11.83 | 3 | 0.001 | 74.6% | 0.758 | 0.230 | 1.286 | < 0.001 | 36 |
| Gender: male | 1 | 120 | 0 | 0 | / | / | 1.587 | 1.175 | 1.999 | < 0.001 | 14 |
| Cancer type: breast | 5 | 410 | 20.31 | 4 | < 0.001 | 80.3% | 0.946 | 0.445 | 1.447 | < 0.001 | 85 |
| Cancer type: other/mixed | 8 | 775 | 26.79 | 7 | < 0.001 | 73.9% | 1.367 | 1.043 | 1.691 | < 0.001 | 559 |
| Cancer present: Yes | 6 | 610 | 36.08 | 5 | < 0.001 | 86.1% | 1.346 | 0.852 | 1.840 | < 0.001 | 323 |
| Cancer present: No | 7 | 575 | 16.23 | 6 | 0.013 | 63.0% | 1.106 | 0.791 | 1.421 | < 0.001 | 244 |
| Cancer stage: 0–3 | 6 | 417 | 8.62 | 5 | 0.125 | 42.0% | 0.997 | 0.714 | 1.280 | < 0.001 | 150 |
| Cancer stage: 2–4 | 4 | 520 | 11.17 | 3 | 0.011 | 73.1% | 1.669 | 1.265 | 2.074 | < 0.001 | 259 |
| Cancer stage: NR | 3 | 248 | 12.36 | 2 | 0.002 | 83.8% | 1.035 | 0.322 | 1.749 | < 0.001 | 39 |
| Resilience measurement tool: RS | 1 | 40 | 0 | 0 | / | / | 0.525 | −0.107 | 1.156 | < 0.001 | 0 |
| Resilience measurement tool: CD-RISC | 12 | 1145 | 47.92 | 11 | 0.001 | 77.0% | 1.251 | 0.970 | 1.531 | < 0.001 | 1085 |
| Resilience as secondary outcome | 7 | 433 | 16.14 | 6 | 0.013 | 62.8% | 0.991 | 0.644 | 1.337 | < 0.001 | 452 |
| Resilience as primary outcome | 6 | 752 | 20.93 | 5 | 0.001 | 76.1% | 1.416 | 1.074 | 1.758 | < 0.001 | 151 |
| Intervention type: traditional CBT | 7 | 745 | 24.84 | 6 | 0.001 | 75.8% | 1.400 | 1.059 | 1.742 | < 0.001 | 503 |
| Intervention type: contemporary CBT | 6 | 440 | 20.42 | 5 | 0.001 | 75.5% | 0.936 | 0.500 | 1.372 | < 0.001 | 123 |
| CBT format: individual | 8 | 574 | 20.09 | 7 | 0.005 | 65.2% | 1.146 | 0.825 | 1.466 | < 0.001 | 305 |
| CBT format: group | 4 | 513 | 14.11 | 3 | 0.003 | 78.7% | 1.479 | 1.032 | 1.927 | < 0.001 | 217 |
| CBT format: couple | 1 | 98 | 0 | 0 | / | / | 0.564 | 0.160 | 0.968 | < 0.001 | 1 |
| CBT delivery: face-to-face | 10 | 793 | 38.98 | 9 | 0.001 | 76.9% | 1.103 | 0.769 | 1.438 | < 0.001 | 500 |
| CBT delivery: mobile device | 3 | 392 | 9.95 | 2 | 0.007 | 79.9% | 1.472 | 0.966 | 1.978 | < 0.001 | 127 |
| CBT duration, weeks ≤ 6 | 7 | 580 | 39.02 | 6 | 0.001 | 84.6% | 1.217 | 0.737 | 1.696 | < 0.001 | 306 |
| CBT duration, weeks > 6 | 5 | 505 | 11.91 | 4 | 0.018 | 66.4% | 1.248 | 0.885 | 1.611 | < 0.001 | 189 |
| CBT duration, weeks: NR | 1 | 100 | 0 | 0 | / | / | 0.973 | 0.557 | 1.388 | < 0.001 | 5 |
Abbreviations: CBT cognitive behavioral therapy, RS Resilience Scale, CD-RISC Conner‒Davison Resilience Scale
aEffect size: Hedges’s g positive value indicates an effect size in the hypothesized direction. All pooled effect sizes were obtained using a random effects model and categorized as follows: small (0.2), medium (0.5), or large (0.8)
⇃Q statistic: P values < 0.1 indicated high heterogeneity. I2 statistics: 0% (no heterogeneity), 25% (low heterogeneity), 50% (moderate heterogeneity), and 75% (high heterogeneity). Meta-analysis was conducted using a random effects model
‡Failsafe No: Number of nonsignificant studies for which the P value was nonsignificant (P > 0.05)