The Effectiveness of Telemedicine-Based Psychosocial Intervention for Fear of Cancer Recurrence, Mindfulness, and Posttraumatic Growth in Cancer Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

[BACKGROUND] With the continuous advancement of cancer treatment technology, the proportion of cancer survivors is gradually increasing, but they also face many psychological challenges. These challenges can seriously affect their quality of life. Telemedicine, as an innovative medical service model, can be combined with psychosocial intervention to provide cancer survivors with convenient, economical and accessible services to assist them in more effectively managing the difficulties posed by cancer and enhancing their overall well-being.

[OBJECTIVE] This meta-analysis sought to assess the impact of telemedicine-based psychosocial interventions on fear of cancer recurrence, mindfulness, and posttraumatic growth in cancer survivors and to explore the influence of intervention duration, the age of participants, and specific online intervention methods on posttraumatic growth.

[DESIGN] A systematic review and meta-analysis of randomized controlled trials was performed, in accordance with the PRISMA 2020 statement.

[METHODS] The meta-analysis included 11 randomized controlled trials involving 1951 cancer survivors. Data were extracted and analyzed via Review Manager 5.4, with supplementary robust variance estimation (RVE) and RVE-based meta-regression (R 4.5.1, robumeta) for robustness. Subgroup analyses were performed on the basis of the intervention duration, the age of the participants, the gender of the participants, the specific online intervention methods, and the follow-up time.

[RESULTS] Psychosocial interventions based on telemedicine significantly reduced cancer survivors' levels of fear of cancer recurrence (SMD = -0.37, 95% CI: -0.52 to -0.21, p < 0.0001) and increased their levels of mindfulness (SMD = -0.87, 95% CI: -1.69 to -0.04, p = 0.04) and posttraumatic growth (MD = 5.96, 95% CI: 3.57-8.36, p < 0.00001). RVE confirmed the robustness of core findings. Subgroup analyses revealed that less than 8 weeks of interventions, interventions targeting participants aged 60 and under, interventions for female participants only, telephone-based online interventions, and with a follow-up of ≤ 6 months interventions were more likely to be effective in promoting PTG.

[CONCLUSION] Psychosocial interventions based on telemedicine can effectively alleviate the fear of cancer recurrence, improve mindfulness, and promote posttraumatic growth in cancer survivors. The duration of the intervention, the age of the participants, the gender of the participants, the specific online intervention methods, and the follow-up time affect the effectiveness of the intervention. RVE further validates conclusion robustness. Additional studies are required to evaluate the enduring effects of these interventions, to understand the degree of patient involvement in digital interventions, and to examine how cultural context, socioeconomic position, and other variables might affect the intervention outcomes.

[TRAIL REGISTRATION] CRD42024611421.