Conectar
Loneliness and social isolation are prevalent and persistent in cancer patients, affecting their psychosocial adjustment. Non-pharmacological interventions have been shown to be effective in previous studies; however, the most effective types of non-pharmacological interventions for this population remain unclear.
The aim of this systematic review and network meta-analysis (NMA) was to synthesize the existing evidence and compare the effectiveness of different types of non-pharmacological interventions in treating loneliness and social isolation among cancer patients.
A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and MEDLINE databases from their inception to December 2024. Randomized controlled trials (RCTs) evaluating non-pharmacological interventions targeting loneliness and social isolation in cancer patients were included. NMA was performed using Stata 17.0 software under a frequentist framework.
A total of 13 RCTs were included, including 9 non-pharmacological interventions and 1151 cancer patients. In order of probability, group logotherapy (SUCRA: 99.9%, SMD: −1.62, 95% CI: −2.23 to −1.01) was the most effective intervention for alleviating loneliness and social isolation, followed by psychoeducational therapy (SUCRA: 76.9%, SMD: −0.62, 95% CI: −1.16 to −0.07) and supportive expressive group therapy (SUCRA: 65.7%, SMD: −0.40, 95% CI: −0.75 to −0.05).
The NMA suggests that, in terms of short-term efficacy, group logotherapy may be considered the optimal choice for reducing loneliness and social isolation levels in cancer patients. Healthcare professionals could regularly conduct group logotherapy among cancer patients to promote their psychosocial adaptation.
PROSPERO Registration Number: CRD42024616937
Cognitive decline, including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, significantly affects social participation, leading to social isolation and reduced quality of life. Enhancing social participation through interventions may mitigate these effects, yet evidence on intervention effectiveness and mechanisms remains inconsistent.
To evaluate the effectiveness of social participation interventions for individuals with cognitive decline and identify effective behavior change techniques (BCTs) supporting social participation.
Our search using the following databases—PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Scopus, CNKI, and Wanfang—was conducted until October 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.4 and Stata18, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Sixteen RCTs involving 2190 participants were included. Music therapy (SMD = 0.62, 95% CI [0.15, 1.10]) and reminiscence therapy (SMD = 0.34, 95% CI [0.02, 0.66]) demonstrated significant positive effects on social participation. Group-based interventions were particularly effective (SMD = 0.23, 95% CI [0.04, 0.43]). Commonly used BCTs included goal setting, behavioral practice/rehearsal, and social support. However, substantial heterogeneity and limited data on SCD and MCI restricted generalizability.
Interventions promoting social participation may enhance engagement for individuals with cognitive decline, particularly through music therapy, reminiscence therapy, and group-based formats. The complexity and dynamic nature of social interaction require individuals to engage and integrate various cognitive functions and skills, which can present significant challenges for older adults with cognitive impairments in their daily social participation. Further research is needed to optimize intervention components and address gaps in targeting early cognitive decline stages.
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