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對(duì)癌癥相關(guān)疲勞的自我管理支持

來(lái)源：泰然健康網(wǎng) 時(shí)間：2024年12月22日 17:15

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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(duì)經(jīng)歷癌癥相關(guān)疲勞的個(gè)人的理論、組成部分和有效性。

方法

根據(jù)系統(tǒng)評(píng)價(jià)和元分析 2020 聲明的首選報(bào)告項(xiàng)目報(bào)告了系統(tǒng)評(píng)價(jià)。對(duì) CINAHL、PubMed、Cochrane CENTRAL 和 EMBASE 進(jìn)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(jī)對(duì)照試驗(yàn)。數(shù)據(jù)由兩位作者篩選、提取和評(píng)估。數(shù)據(jù)提取由自我管理支持分類法（即針對(duì)癌癥的自我管理支持分類法實(shí)用評(píng)論的修改版）指導(dǎo)。修訂后的 Cochrane 偏倚風(fēng)險(xiǎn)工具用于研究評(píng)估。進(jìn)行了批判性的敘事綜合。

結(jié)果

確定了代表 50 項(xiàng)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(guò)面對(duì)面（即“面對(duì)面”）接觸（40%）進(jìn)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(gè)）。31 項(xiàng)研究 (62%) 描述了一種特定的行為改變理論來(lái)指導(dǎo)他們的自我管理支持干預(yù)的發(fā)展。29 項(xiàng)研究 (n=29/50; 58%) 報(bào)告了干預(yù)后立即對(duì)疲勞產(chǎn)生積極的干預(yù)效果。在這 29 項(xiàng)研究中，10 項(xiàng) (34%) 報(bào)告了在 2 至 12 個(gè)月的隨訪期間對(duì)疲勞至少有一項(xiàng)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(duì)面的接觸，似乎會(huì)產(chǎn)生最有利的疲勞和行為結(jié)果。然而，需要進(jìn)一步的工作來(lái)更好地理解個(gè)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(xiàng)目開(kāi)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(kāi)發(fā)、實(shí)施和評(píng)估中的應(yīng)用；確保促進(jìn)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(lái)的研究應(yīng)納入充分的后續(xù)行動(dòng)，以充分評(píng)估計(jì)劃對(duì)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(hù)士最相關(guān)，因?yàn)樽o(hù)士是最大的癌癥護(hù)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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