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September 15, 2011Journal of Behavioral Medicine310 citationsOpen Access

The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis

SLS.M.A. LamersLBLinda BolierGWGerben J. Westerhof

Key Result

Higher baseline levels of emotional well-being significantly predicted better long-term recovery and survival in physically ill patients, with an overall likelihood ratio of 1.14.

Study Design

Type

Meta-Analysis (n=12,744)

Structured PICO

Does emotional well-being improve recovery and survival in physically ill patients?

P
Population
17 prospective studies pooling 12,744 physically ill patients (including heart and vascular diseases, cancer, renal disease, spinal cord injury, HIV, diabetes, arthritis, stroke, hip fracture, respiratory disorder, and general medical patients).
I
Intervention
Higher levels of emotional well-being (measured as general well-being, positive affect, or life satisfaction)
C
Comparator
Lower levels of emotional well-being
O
Outcome
Prognosis of physical illness, specifically survival (survival status or time) and recovery (functional status or health status)

Higher levels of emotional well-being are associated with a small but significant improvement in long-term recovery and survival among physically ill patients.

Main Result

Effect estimate: LR 1.14

p-value: p=<0.001

Limitations

  • High heterogeneity across studies due to diverse covariates, health outcomes, and study populations
  • Potential publication bias, suggesting the effects of emotional well-being might be overestimated
  • Most studies used subscales from depression scales to measure positive affect, which may have low subscale reliability
  • Few studies controlled for negative aspects of mental health such as psychopathology to evaluate the unique effects of emotional well-being
  • High heterogeneity across the included studies
  • Presence of publication bias indicating effects might be overestimated
  • Low reliability of well-being scales in some included studies (Cronbach's alpha < 0.60 or not reported)
  • Lack of objective recovery measurements in most functional status studies

Abstract

This meta-analysis synthesized studies on emotional well-being as predictor of the prognosis of physical illness, while in addition evaluating the impact of putative moderators, namely constructs of well-being, health-related outcome, year of publication, follow-up time and methodological quality of the included studies. The search in reference lists and electronic databases (Medline and PsycInfo) identified 17 eligible studies examining the impact of general well-being, positive affect and life satisfaction on recovery and survival in physically ill patients. Meta-analytically combining these studies revealed a Likelihood Ratio of 1.14, indicating a small but significant effect. Higher levels of emotional well-being are beneficial for recovery and survival in physically ill patients. The findings show that emotional well-being predicts long-term prognosis of physical illness. This suggests that enhancement of emotional well-being may improve the prognosis of physical illness, which should be investigated by future research.

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Cite This Study

Lamers et al. (2011) conducted a meta-analysis in Physical illness (n=12,744). Emotional well-being (positive affect, life satisfaction, general well-being) vs. Lower levels of emotional well-being was evaluated on Prognosis of physical illness (survival and recovery) (LR 1.14, p=<0.001). Higher baseline levels of emotional well-being significantly predicted better long-term recovery and survival in physically ill patients, with an overall likelihood ratio of 1.14.

synapsesocial.com/papers/6a0e16e7feb2455d62c828bahttps://doi.org/10.1007/s10865-011-9379-8
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