Effects of interventions on rumination among individuals with cancer: A systematic review and meta-analysis

Aim This study aimed to examine the effects of interventions on rumination among individuals with cancer. Design A systematic review and meta-analysis. Data Sources Six databases (Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), PsyArticles, CINAHL, PubMed and Web of Science) were searched for relevant articles published between January 2000 and April 2020. Review methods The findings of experimental studies (including both experimental and control groups) related to interventions to effect rumination of individuals with cancer were included. Comprehensive meta-analysis was used to analyse the data. Hedges' g and 95% confidence intervals (CIs) were computed to estimate the effect. Additionally, funnel plots were created and heterogeneity was analysed using the I-2 test. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used. Results Eight studies, which included a total sample of 856 individuals with cancer, were included. Half of the studies (n = 4) were randomised controlled trials, and six of them had conducted mindfulness-based interventions. The interventions had significant effects on rumination among individuals with cancer (z = -2.356, Q = 167.663, p < 0.001, I-2 = 95.825%). The effect size was -0.894 (95% CI = [-1.638, -0.150]) and statistically significant (p < 0.001). Conclusion The interventions had reduced rumination among individuals with cancer. These effects should be interpreted with caution because there was a high level of heterogeneity. However, only a few studies were included, and the findings underscore the need for further research. Impact Many individuals are likely to benefit from rumination-focused interventions, especially mindfulness-based interventions. Nurses should utilise available opportunities to facilitate the optimal management of cancer-related rumination.