The effectiveness of nurse-led interventions for cancer symptom management 2000-2018: A systematic review and meta-analysis

Kelly, Daniel ORCID: https://orcid.org/0000-0002-1847-0655, Campbell, Pauline, Torrens, Claire, Charalambous, Andreas, Östlund, Ulrika, Eicher, Manuela, Larsson, Maria, Nohavova, Iveta, Olsson, Cecilia, Simpson, Mhairi, Patiraki, Elisabeth, Sharp, Lena, Wiseman, Theresa, Oldenmenger, Wendy and Wells, Mary 2022. The effectiveness of nurse-led interventions for cancer symptom management 2000-2018: A systematic review and meta-analysis. Health Sciences Review 4 , 100052. 10.1016/j.hsr.2022.100052

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Abstract

Background Evidence for effectiveness of nurse-led interventions for cancer-related symptoms is of variable quality. This study aimed to identify, appraise and evaluate the nature and effectiveness of nurse-led interventions on symptoms for people with cancer. Methods A systematic review and meta-analysis. Ten major databases were searched (2000 to 2018, no language restrictions). Two reviewers applied a priori selection criteria; data extraction included design, population, cancer type, and cancer-related symptoms. Interventions and providers were profiled using TIDieR reporting guidelines, and content analysis of components. Methodological quality was assessed using Cochrane risk of bias. A meta-analysis was performed using mean and standardised mean differences with 95% confidence intervals. Overall certainty was assessed using GRADE. Results From 29193 records, 149 studies (n = 107286 participants) from 22 countries were eligible. Interventions included multiple components; education and psychological approaches dominated. Pooled meta-analyses found evidence of benefit for nurse-led interventions on measures of constipation (MD −4.54, 95% CI −8.08 to −0.99; 645 participants; 6 trials; I2 = 0%; P = 0.01); nausea and vomiting (MD −1.97, 95% CI −3.61 to −0.33; 957 participants; 8 trials; I 2 = 12%; P = 0.02) and fatigue (MD −4.63, 95% CI −7.97 to −1.30; 1208 participants; 11 trials; I2 = 34%; P = 0.007). Psychological morbidity (anxiety, depression, mood) also improved. However, few trials used consistent outcome measures, interventions were poorly defined, and certainty of evidence was low or very low. Conclusion Nurse-led interventions improve specific cancer-related symptoms, including psychological morbidity. Enhanced reporting and collaboration to develop a minimum core dataset would strengthen the quality of evidence.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Additional Information:	This is an open access article under the terms of the CC-BY Attribution 4.0 International license.
Publisher:	Elsevier
ISSN:	2772-6320
Date of First Compliant Deposit:	9 September 2022
Date of Acceptance:	22 August 2022
Last Modified:	03 May 2023 09:41
URI:	https://orca.cardiff.ac.uk/id/eprint/152314

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