Effectiveness of integrated nursing interventions for fatigue in patients with advanced cancer: a systematic review of randomized controlled trials
, , and | Nov 07, 2019
About this article
Article Category: Original article
Published Online: Nov 07, 2019
Page range: 203 - 210
Received: Jul 17, 2018
Accepted: Dec 23, 2018
DOI: https://doi.org/10.2478/FON-2019-0027
Keywords
© 2019 Xiao-Lin Zuo et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
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Characteristics of the study instruments and samples.
| Studies | Country/setting | Study sample | Intervention | Control | Measurement tools and time points | Results |
|---|---|---|---|---|---|---|
| Steel et al. | USA/a large tertiary cancer center | 226 advanced liver cancer patients I: n=108; C: n=118 Age: 18 years or older | Stepped collaborative care | Usual care | FACT-F, baseline, and at 2, 4, and 6 months | The fatigue score was greatly reduced in the intervention group* |
| Kwekkeboom et al. | USA/a comprehensive cancer center | 86 advanced lung, prostate, colorectal, or gynecologic cancers I: n=43 (14 males); age: 60.4±10.8 years C: n=43 (21 males); age: 60.1±11.5 years | Cognitive behavior | Waitlist control | BFI, baseline, and at 2 weeks later | The intervention group reported less fatigue at 2 weeks than the control group* |
| Chuang et al. | Taiwan/ Departments of Oncology and Hematology | 100 advanced cancer patients I: n=50 (24 males); age: 47.2±10.7 years C: n=50 (29 males); age: 47.2±10.6 years | Chan-Chuang qigong | Usual care | BFI and muscular strength, baseline, and at 21 days later | The fatigue score was greatly reduced in the intervention group* |
| Headley et al. | USA/outpatient clinic of a comprehensive cancer center | 38 patients with advanced breast cancer who were started to undergo outpatient chemotherapy. I: n=16; age: 52.25±11.43 years C: n=16; age: 50.0±7.10 years | Seated exercise | Usual physical activity | FACT-F, baseline, and at the beginning of next three chemotherapy cycles | FACT-F scores declined at a significant rate* |
| de Raaf et al. | The Netherlands/ outpatient clinic of a comprehensive cancer center | 152 advanced cancer patients I: n=76 (31 males); age: 57±9.7 years C: n=76 (34 males); age: 59±10.5 years | Protocolized patient-tailored care | Usual care | MFI, baseline and, at 1, 2, 3 months | The intervention group revealed significant improvements in managing fatigue* |
| Chan et al. | Hong Kong/ outpatient clinic of a publicly funded hospital | 140 advanced (stage 3 or 4) lung cancer patients I: n=70 (58 males) C: n=70 (58 males) Age: 18 years or older | Psychoeducation | Usual care | The revised Piper Fatigue Scale, baseline, and at 3, 6, and 12 weeks later | The fatigue score was greatly reduced in the intervention group* |
Characteristics of interventions.
| Studies | Intervention performers | Adherence to delivery protocols | Duration and intensity | Patient adherence | Summary of intervention content |
|---|---|---|---|---|---|
| Steel et al. | Nurse coordinators and psychologists | Trained telephone interviewers follow a structured clinical interview | 60 minutes | Telephone | Education, self-management, journaling, a chat room, an audiovisual library, and peer support |
| Kwekkeboom et al. | A research nurse | Training sessions were audio-recorded and intervention fidelity was assessed with a checklist | A start and a final study meeting. Patients were encouraged to practice at least once per day for approximately 20 minutes long for 2 weeks during cancer treatment | Diary, telephone, and mail | Relaxation, imagery, or distraction exercises via an educational booklet and MP3 player |
| Chuang et al. | Nurse specialists and physiotherapists | No data | 21 days in addition to conventional care | Training session | Relaxation, body awareness, and qigong training |
| Headley et al. | Nursing specialists | No data | A 30-minute seated exercise program three times a week with at least 1-day break between sessions | Monthly calendar log | Five-minute warm-up, 20 minutes of moderate-intensity repetitive motion exercises, and 5-minute cooldown |
| de Raaf et al. | Nurse specialists | No data | Train meetings within 1 week after random assignment, after 2–4 weeks, after 5–7 weeks, and after 8–10 weeks | Education and non-pharmacological interventions | |
| Chan et al. | Registered nurses with 2 years of clinical experience | A 2-day training session focusing on the educational package and progressive muscle relaxation | A 40-minute educational package plus coaching of progressive muscle relaxation | Telephone and diary | Leaflets and discussion on the selected symptoms and their self-care management |