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癌症幸存者的自我管理干预措施:系统评价。

Self-management interventions for cancer survivors: a systematic review.

机构信息

Discipline of Occupational Therapy, Trinity College Dublin, Trinity Centre for Health Sciences, St. James's Hospital, James's Street, Dublin 8, DO8 W9RT, Ireland.

Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Support Care Cancer. 2018 May;26(5):1585-1595. doi: 10.1007/s00520-017-3999-7. Epub 2017 Dec 4.

Abstract

PURPOSE

Many cancer survivors experience problems with persisting symptoms such as pain, fatigue, anxiety and depression post-treatment. Self-management interventions are recommended for cancer patients as they can help individuals identify and manage these continuing symptoms. This systematic review examines the type, content and impact of self-management interventions for cancer survivors on health outcomes such as activity participation, self-efficacy, quality of life and symptom management.

METHODS

This was a systematic review of the English language scientific literature searched for randomised controlled trials (RCT), systematic reviews and meta-analyses of self-management programmes conducted with cancer survivors. Six databases were systematically searched.

RESULTS

Initial searches yielded 2633 citations. Following screening and a risk of bias assessment, six studies were included in the final review. Heterogeneity of the interventions precluded meta-analysis. Three studies reported significant differences between groups in a number of areas including fatigue, physical functioning, distress and self-efficacy at their first follow-up assessment. These studies included two psychosocial interventions and one exercise and diet intervention. Not all findings were sustained across studies at follow-up assessment.

CONCLUSION

It is not possible to draw definitive conclusions as to the impact the different types of self-management programme had on cancer survivors. The sustainability of the interventions reviewed was poor, suggesting that cancer survivors require interventions that can be applied into their daily activities.

摘要

目的

许多癌症幸存者在治疗后会出现持续存在的症状,如疼痛、疲劳、焦虑和抑郁。建议对癌症患者进行自我管理干预,因为它们可以帮助个人识别和管理这些持续存在的症状。本系统评价检查了针对癌症幸存者的自我管理干预措施的类型、内容和对健康结果的影响,如活动参与、自我效能、生活质量和症状管理。

方法

这是对英文科学文献的系统评价,检索了针对癌症幸存者的自我管理计划的随机对照试验 (RCT)、系统评价和荟萃分析。系统地搜索了六个数据库。

结果

初步搜索产生了 2633 条引文。经过筛选和风险评估,最终有六项研究纳入了最终的综述。干预措施的异质性排除了荟萃分析。三项研究报告了在许多领域(包括疲劳、身体功能、困扰和第一次随访评估时的自我效能)组间存在显著差异。这些研究包括两项心理社会干预措施和一项运动和饮食干预措施。并非所有研究结果在随访评估时都能持续存在。

结论

无法确定不同类型的自我管理方案对癌症幸存者的影响。所审查的干预措施的可持续性很差,这表明癌症幸存者需要可以应用于日常生活活动的干预措施。

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