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Abstract

Objectives

To describe and examine the theories, components, and effectiveness of self-management support interventions for individuals experiencing cancer-related fatigue.

Methods

A systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. CINAHL, PubMed, Cochrane CENTRAL, and EMBASE were searched (from inception to June 2021) for randomised controlled trials examining self-management support interventions for managing cancer-related fatigue. Data were screened, extracted, and appraised by two authors. Data extraction was guided by the Self-management Support Taxonomy (i.e., a modified version of the Practical Reviews in Self-Management Support Taxonomy tailored to cancer). The Revised Cochrane Risk of Bias tool was used for study appraisal. A critical narrative synthesis was conducted.

Results

Fifty-one papers representing 50 different studies (n= 7,383) were identified. Most interventions were delivered post-treatment (40%) using in-person (i.e., ‘face-to-face’) encounters (40%), and were facilitated by health professionals (62%). A range of intervention approaches and self-management support strategies were used across studies. The average number of Self-management Support Taxonomy components used across studies was 6.1 (of 14). Thirty-one studies (62%) described a specific behaviour change theory to guide their self-management support intervention development. Twenty-nine studies (n=29/50; 58%) reported a positive intervention effect for fatigue immediately post-intervention. Of these 29 studies, 10 (34%) reported at least one sustained positive effect on fatigue over follow-up periods between two and 12 months.

Conclusions

Self-management support that is delivered after cancer treatment, facilitated by health professionals, and incorporating at least one in-person contact appears to produce the most favourable fatigue and behavioural outcomes. However, further work is needed to better understand how individual self-management support strategies and the application of a behavioural theory influence behaviour change. Program developers should guide self-management support with a behavioural theory, and describe their theory application in intervention development, implementation, and evaluation; ensure facilitators receive adequate support training; and seek the delivery preferences of cancer survivors. Future research should incorporate adequate follow-up to sufficiently evaluate the impact of programs on cancer-related fatigue and associated self-management behaviours. Findings from this review are relevant to all healthcare professionals, but are of most relevance to nurses as the largest cancer care workforce with a key role in delivering self-management support.

摘要翻譯（僅供參考）

目標(biāo)

描述和檢查自我管理支持干預(yù)對經(jīng)歷癌癥相關(guān)疲勞的個人的理論、組成部分和有效性。

方法

根據(jù)系統(tǒng)評價和元分析 2020 聲明的首選報告項目報告了系統(tǒng)評價。對 CINAHL、PubMed、Cochrane CENTRAL 和 EMBASE 進行了搜索（從成立到 2021 年 6 月），以尋找用于管理癌癥相關(guān)疲勞的自我管理支持干預(yù)措施的隨機對照試驗。數(shù)據(jù)由兩位作者篩選、提取和評估。數(shù)據(jù)提取由自我管理支持分類法（即針對癌癥的自我管理支持分類法實用評論的修改版）指導(dǎo)。修訂后的 Cochrane 偏倚風(fēng)險工具用于研究評估。進行了批判性的敘事綜合。

結(jié)果

確定了代表 50 項不同研究的 51 篇論文（n = 7,383）。大多數(shù)干預(yù)措施是在治療后（40%）通過面對面（即“面對面”）接觸（40%）進行的，并由衛(wèi)生專業(yè)人員（62%）協(xié)助。在研究中使用了一系列干預(yù)方法和自我管理支持策略。研究中使用的自我管理支持分類組件的平均數(shù)量為 6.1（共 14 個）。31 項研究 (62%) 描述了一種特定的行為改變理論來指導(dǎo)他們的自我管理支持干預(yù)的發(fā)展。29 項研究 (n=29/50; 58%) 報告了干預(yù)后立即對疲勞產(chǎn)生積極的干預(yù)效果。在這 29 項研究中，10 項 (34%) 報告了在 2 至 12 個月的隨訪期間對疲勞至少有一項持續(xù)的積極影響。

結(jié)論

癌癥治療后提供的自我管理支持，由衛(wèi)生專業(yè)人員協(xié)助，并結(jié)合至少一次面對面的接觸，似乎會產(chǎn)生最有利的疲勞和行為結(jié)果。然而，需要進一步的工作來更好地理解個人自我管理支持策略和行為理論的應(yīng)用如何影響行為改變。項目開發(fā)人員應(yīng)以行為理論指導(dǎo)自我管理支持，并描述其理論在干預(yù)開發(fā)、實施和評估中的應(yīng)用；確保促進者接受足夠的支持培訓(xùn)；并尋求癌癥幸存者的分娩偏好。未來的研究應(yīng)納入充分的后續(xù)行動，以充分評估計劃對癌癥相關(guān)疲勞和相關(guān)自我管理行為的影響。本次審查的結(jié)果與所有醫(yī)療保健專業(yè)人員相關(guān)，但與護士最相關(guān)，因為護士是最大的癌癥護理人員，在提供自我管理支持方面發(fā)揮著關(guān)鍵作用。

原文鏈接：

https://doi.org/10.1016/j.ijnurstu.2022.104206

THEEND

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