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数字自我管理干预对儿童癌症幸存者健康结局的影响:系统评价和荟萃分析。

The effectiveness of digital self-management interventions on health outcomes among childhood cancer survivors: A systematic review and meta-analysis.

机构信息

Department of Nursing, Chung-Ang University, Seoul, South Korea.

College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea.

出版信息

J Adv Nurs. 2021 Nov;77(11):4387-4399. doi: 10.1111/jan.14925. Epub 2021 Jun 15.

Abstract

AIMS

The study aimed to review the evidence about existing digital interventions for childhood cancer survivors and examine their effectiveness on health outcomes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PUBMED, EMBASE, Cochrane, CINAHL, Web of Science, PsycArticles, SCOPUS and PQDT Global databases were searched, and the date last searched was 16 September 2019.

REVIEW METHODS

This systematic review followed PRISMA guidelines. Randomized and nonrandomized controlled trials, as well as before-and-after studies, were included. The main outcomes were health-related quality of life and moderate-to-vigorous physical activity. Two authors independently reviewed included studies and assessed methodological quality. Meta-analysis was conducted using statistical software STATA 16.0.

RESULTS

Out of the eight eligible studies, four were included in the meta-analysis. The digital self-management interventions were not effective on health-related quality of life and moderate-to-vigorous physical activity. Additionally, the digital self-management interventions increased the moderate-to-vigorous physical activity over time but was not statistically significant.

CONCLUSIONS

There is insufficient evidence on the effectiveness of digital self-management interventions in improving health outcomes among childhood cancer survivors. Future randomized controlled trials should be conducted from multiple locations and should include objective measures and means to encourage interaction with health care providers.

IMPACT

Digital interventions are increasingly implemented to improve health outcomes among childhood cancer survivors, but their results are inconsistent. Well-designed digital interventions may be beneficial for this population over time. The recommendations proposed in the current review may be useful for developing digital interventions and designing related studies in the future, thereby reducing late effects and improving healthy behaviours among this population.

摘要

目的

本研究旨在回顾现有针对儿童癌症幸存者的数字干预措施的证据,并考察其对健康结果的有效性。

设计

系统评价和荟萃分析。

资料来源

PubMed、Embase、Cochrane、CINAHL、Web of Science、PsycArticles、SCOPUS 和 PQDT Global 数据库进行检索,最后检索日期为 2019 年 9 月 16 日。

评价方法

本系统评价遵循 PRISMA 指南。纳入随机和非随机对照试验以及前后对照研究。主要结局为健康相关生活质量和中等到剧烈体力活动。两位作者独立审查纳入的研究并评估方法学质量。使用统计软件 STATA 16.0 进行荟萃分析。

结果

在八项合格研究中,有四项纳入荟萃分析。数字自我管理干预措施对健康相关生活质量和中等到剧烈体力活动没有效果。此外,数字自我管理干预措施随着时间的推移增加了中等到剧烈体力活动,但无统计学意义。

结论

关于数字自我管理干预措施在改善儿童癌症幸存者健康结果方面的有效性,证据不足。未来应在多个地点进行随机对照试验,并应包括客观测量和鼓励与医疗保健提供者互动的手段。

影响

数字干预措施越来越多地被用于改善儿童癌症幸存者的健康结果,但结果不一致。精心设计的数字干预措施可能随着时间的推移对这一人群有益。目前综述中提出的建议可能有助于未来开发数字干预措施和设计相关研究,从而减少这一人群的晚期效应并改善健康行为。

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