A systematic review of the effects of character strengths-based intervention on the psychological well-being of patients suffering from chronic illnesses.
AIMS
To identify and evaluate the available evidence on the effectiveness of character strengths-based intervention on the psychological well-being of patients with chronic illnesses.


DESIGN
A systematic review with meta-analysis.


DATA SOURCES
Six electronic databases, including PubMed, EMBASE, EBSCO (CINAHL® and MEDLINE), Web of Science, and PsycINFO, were searched from inception to December 2018.


REVIEW METHODS
The quality appraisal of evidence and summary of studies were undertaken following Joanna Briggs Institute critical appraisal checklists and the standard guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analysis was conducted according to Cochrane methods using RevMan 5.1.


RESULTS
Clinical studies on the character strengths-based intervention for patients with chronic illnesses are limited. Eight studies involving 692 patients were identified and critically appraised in this review. Meta-analysis results for three comparable studies indicated that character strengths-based intervention was effective in improving the self-esteem of patients with chronic illnesses and it significantly enhanced their general self-efficacy and reduced their depression.


CONCLUSIONS
The findings support the effectiveness of character strengths-based intervention on improving the psychological well-being of patients with chronic illnesses. However, caution is needed in interpreting these results due to limited studies and heterogeneity across studies. Further research is needed to provide strong evidence on the applicability of the intervention in clinical practice.


IMPACT
This rigorous review provided current evidence on using character strengths-based intervention to improve the psychological well-being of patients with chronic illnesses. Character strengths-based intervention provides a creative approach for patients because it may help improve their well-being, happiness, self-esteem, and self-efficacy, and reduce depression and mental symptoms. Studies in different groups of patients suffering from chronic illnesses are recommended in the future. The character strengths-based intervention should be replicated in various inpatient facilities and include a larger and a more ethnically and socioeconomically diverse sample.
['Yan|Tingting|T|https://orcid.org/0000-0002-2368-9248', 'Chan|Carmen W H|CWH|https://orcid.org/0000-0003-0696-2369', 'Chow|Ka Ming|KM|https://orcid.org/0000-0002-7442-5197', 'Zheng|Wei|W|', 'Sun|Meng|M|']
D001007:Anxiety D002908:Chronic Disease D006801:Humans D012649:Self Concept D020377:Self Efficacy
systematic review strengths-based psychological well-being chronic illness character strengths nursing positive psychology psychosocial intervention