title: Effects of cognitive behavioral therapy on quality of life and stress for breast cancer survivors: a meta-analysis.
abstract: BACKGROUND
  Cognitive behavioral therapy (CBT) has been shown to be effective in mitigating various psychosocial impacts from breast cancer. Long-term studies have yielded mixed findings on the outcome of CBT in breast cancer settings, especially with respect to quality of life (QOL) and the quantified degree of stress (QDS).
  
  
  METHODS
  Medline, Cochrane, Embase, and Google Scholar databases were searched and randomized controlled trials relevant to the use of CBT and its variants in breast cancer patients were selected, and their pooled results meta-analyzed.
  
  
  RESULTS
  Six studies qualified for inclusion in the meta-analysis. Results from the six pooled studies did not demonstrate that CBT improves QOL (standardized mean difference =-0.016, 95% CI=-0.898 to 0.866, P=0.972) or reduces QDS (standardized mean difference =-0.125, 95% CI=-0.268 to 0.017, P=0.084) for breast cancer survivors. However, interpretation of these results requires caution, given the small number of eligible studies, comprising a total of only 430 patients. Since the literature also includes trials of CBT combined with various other therapies, including hypnosis, exercise treatment, and stress management, with promising results in breast cancer settings, expanded clinical research is likely to demonstrate an overall benefit of CBT.
  
  
  CONCLUSIONS
  Despite the meta-analysis fails to support the use of CBT to improve QOL or reduce stress for breast cancer survivors, CBT appears to be promising as a therapeutic intervention against many of the psychosocial impacts of breast cancer.
authors.affiliation: Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China - zmy196711@163.com.
authors.forename: Meiyun
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Zhixian
authors.initials: Z
authors.lastname: Feng
authors.affiliation: Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Lewen
authors.initials: L
authors.lastname: Shao
authors.affiliation: Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D017741:Survivors / Q000523:psychology*