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Positive Psychology Interventions in Immune Thrombocytopenic Purpura and Other Autoimmune Hematological Disorders: A Systematic Review

Abstract

Background: Autoimmune hematological disorders, including immune thrombocytopenic purpura (ITP), autoimmune hemolytic anemia (AHAI) and Evans syndrome, are characterized by intricate clinical trajectories and significant emotional and psychosocial burdens. Despite mounting evidence on the psychological distress experienced by these patients, the application of positive psychology interventions (PPIs) in this population remains largely unexplored.

Objective: The present study aims to undertake a systematic review and synthesis of the extant literature concerning the utilization of positive psychology-aligned interventions in patients diagnosed with autoimmune hematological disorders. The primary objective is to elucidate the psychological impact of these interventions, the types of interventions employed, the contextual implementation thereof, and to identify any research gaps.

Methodology: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive search strategy was employed, utilizing six major databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL, and Google Scholar). This strategy encompassed a combination of terms related to positive psychology, autoimmune hematological disorders, and psychological outcomes. The inclusion criteria encompassed peer-reviewed studies published from 2015 onwards, involving interventions related to positive psychology, and reporting emotional, psychological or quality-of-life outcomes in patients with ITP, AHAI or Evans syndrome. The quality of the studies was assessed using design-appropriate tools (RoB 2, ROBINS-I, CASP, AXIS, JBI, COSMIN, SANRA), and the certainty of the evidence was graded using the GRADE approach.

Results: Following a comprehensive review of the available literature, 33 studies were deemed to meet the inclusion criteria. To the best of our knowledge, no PPIs have been explicitly implemented. However, several of the included components were implicit, and these comprised resilience, emotional well-being, and  subjective quality of life. The interventions employed in this context were found to be heterogeneous, with the majority being conducted within clinical settings. There appeared to be limited attention paid to cultural or community adaptation in these interventions. The qualitative findings indicated that coping strategies, patient agency, and relational support were identified as key psychological resources. Nevertheless, the absence of structured, theory-driven PPI frameworks limits the ability to draw strong conclusions on their effectiveness.

Conclusions: A critical gap in the literature exists with regard to explicit applications of PPIs in autoimmune hematological disorders. The extant evidence suggests that the integration of positive psychology principles, such as meaning-making, gratitude, resilience, and personal strengths, has the potential to enhance patient well-being and complement medical treatment. It is imperative that further research is conducted in order to develop, implement and evaluate culturally sensitive, evidence-based PPIs that are tailored to the unique challenges of this patient population.

Datos del evento

Palabras claves
  • Positive psychology
  • |
  • Immune thrombocytopenic purpura
  • |
  • Autoimmune hematological disorders
  • |
  • Quality of life
  • |
  • Psychological well-being
  • |
  • Systematic review
  • Pedro Vazquez-Marin, Department of Education, University of Bath, Bath, United Kingdom
  • Sofía Carrasco-Naranjo, Department of Medicine, University of Sevilla, Spain

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