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护士主导的基于电话的支持性干预对癌症患者的影响:一项荟萃分析。

Effects of Nurse-Led Telephone-Based Supportive Interventions for Patients With Cancer: A Meta-Analysis.

作者信息

Suh Soon-Rim, Lee Myung Kyung

机构信息

Kyungpook National University.

出版信息

Oncol Nurs Forum. 2017 Jul 1;44(4):E168-E184. doi: 10.1188/17.ONF.E168-E184.

Abstract

PROBLEM IDENTIFICATION: To evaluate the effects of nurse-led telephone-based supportive interventions (NTSIs) for patients with cancer.
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LITERATURE SEARCH: Electronic databases, including EMBASE®, MEDLINE, Google Scholar, 
Cochrane Library CENTRAL, ProQuest Medical Library, and CINAHL®, were searched through February 2016.
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DATA EVALUATION: 239 studies were identified; 16 were suitable for meta-analysis. Cochrane's risk of bias tool and the Comprehensive Meta-Analysis software were used.
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SYNTHESIS: The authors performed a meta-analysis of 16 trials that met eligibility criteria. Thirteen randomized, controlled trials (RCTs) and three non-RCTs examined a total of 2,912 patients with cancer. Patients who received NTSIs were compared with those who received attentional control or usual care (no intervention).
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CONCLUSIONS: Telephone interventions delivered by a nurse in an oncology care setting reduced cancer symptoms with a moderate effect size (ES) (-0.33) and emotional distress with a small ES (-0.12), and improved self-care with a large ES (0.64) and health-related quality of life (HRQOL) with a small ES (0.3). Subgroup analyses indicated that the significant effects of NTSIs on cancer symptoms, emotional distress, and HRQOL were larger for studies that combined an application of a theoretical framework, had a control group given usual care, and used an RTC design.
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IMPLICATIONS FOR RESEARCH

The findings suggest that an additional tiered evaluation that has a theoretical underpinning and high-quality methodology is required to confirm the efficacy of NTSI for adoption of specific care models.

摘要

问题识别

评估护士主导的基于电话的支持性干预措施(NTSIs)对癌症患者的影响。

文献检索

检索了电子数据库,包括EMBASE®、MEDLINE、谷歌学术、Cochrane图书馆CENTRAL、ProQuest医学图书馆和CINAHL®,检索截至2016年2月。

数据评估

共识别出239项研究;16项适合进行荟萃分析。使用了Cochrane偏倚风险工具和综合荟萃分析软件。

综合分析

作者对16项符合纳入标准的试验进行了荟萃分析。13项随机对照试验(RCTs)和3项非随机对照试验共纳入了2912例癌症患者。将接受NTSIs的患者与接受注意力控制或常规护理(无干预)的患者进行比较。

结论

在肿瘤护理环境中,护士提供的电话干预措施可减轻癌症症状,效应量中等(ES为-0.33),减轻情绪困扰,效应量较小(ES为-0.12),改善自我护理,效应量较大(ES为0.64),并改善健康相关生活质量(HRQOL),效应量较小(ES为0.3)。亚组分析表明,对于结合应用理论框架、有给予常规护理的对照组且采用随机对照试验设计的研究,NTSIs对癌症症状、情绪困扰和HRQOL的显著影响更大。

对研究的启示

研究结果表明,需要进行额外的具有理论基础和高质量方法的分层评估,以确认NTSI在采用特定护理模式方面的疗效。

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