Self-Efficacy as a Mediating Mechanism in the Effect of Psychological Counseling on Quality of Life among Patients with Chronic Diseases: A Meta-Analytic Study

Abstract

This meta-analytic research investigates the mediating role of self-efficacy in the relationship between psychological counseling and quality of life among patients with chronic diseases, synthesizing experimental evidence through a rigorous quantitative methodology. Following PRISMA 2020 guidelines, 74 experimental and quasi-experimental studies underwent initial screening, of which 42 met the predefined PICOS criteria, encompassing a total sample of approximately 28,340 patients (ages 18–67) diagnosed with various chronic conditions including diabetes, cardiovascular diseases, cancer, and chronic respiratory disorders, spanning the period from 2015 to 2026. The meta-analysis revealed a statistically significant overall effect size of psychological counseling on quality of life improvement (g = 0.73, 95% CI: [0.61, 0.85]), and an overall effect on self-efficacy (g = 0.68, 95% CI: [0.57, 0.79]). Meta-analytic Structural Equation Modeling (MASEM) demonstrated that self-efficacy partially and significantly mediated the relationship between psychological counseling and quality of life, accounting for 42.3% of the total indirect effect variance (β = 0.41, p < .001). Subgroup analyses indicated that cognitive-behavioral counseling interventions achieved the highest effect sizes in building self-efficacy among cancer patients (g = 0.81), while diabetes patients demonstrated stronger mediation responses to group counseling programs. These findings establish a comprehensive mechanistic model explaining pathways through which psychological counseling influences quality of life, with clinical implications for integrating self-management-focused counseling into standard treatment protocols for chronic diseases in Arab healthcare systems.