Sato Rika, Naito Tateaki, Hayashi Naoko
Division of Nursing, Shizuoka Cancer Center, Shizuoka, Japan.
Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan.
Asia Pac J Oncol Nurs. 2021 Aug 27;8(5):498-507. doi: 10.4103/apjon.apjon-2152. eCollection 2021 Sep-Oct.
This scoping review aims to identify the barriers in practice and clinical trials for oncology nurses in cancer cachexia. We used the framework proposed by Arksey and O'Malley and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Studies written in English and published between 2008 and 2021 were retrieved from five databases: MEDLINE, Cochrane Library, CINAHL, PsycINFO, and EMBASE. A total of 1075 studies were identified, and 34 full-text studies were assessed for eligibility by three researchers. Seventeen studies met the inclusion criteria. This review revealed several barriers to nursing practice and clinical trials in cancer cachexia. First, health-care professionals, including nurses, faced individual barriers (insufficient understanding and skills for diagnosis and management) and environmental barriers (lack of standardized screening tools or treatment options, difficulties in collaboration with other professions, and limited human resources) in practice. Second, studies on nurse-led interventions for cancer cachexia were relatively few and different in objectives, making it challenging to integrate the outcomes. Finally, there were no established educational programs for nurses that explicitly focused on cancer cachexia. This scoping review revealed individual and environmental barriers in nursing practice. In addition, there have relatively few clinical trials involving oncology nurses in cancer cachexia. Continuing education for nurses should cover cancer cachexia to improve the quality of oncology care in the future. It is also necessary to standardize practical assessment tools that are easy to assess daily and lead to interventions and develop nurse-led multidisciplinary care.
本综述旨在确定肿瘤护理人员在癌症恶病质的实践和临床试验中所面临的障碍。我们采用了阿克西和奥马利提出的框架以及系统评价和Meta分析的首选报告项目扩展版用于范围综述。从五个数据库检索了2008年至2021年间发表的英文研究：MEDLINE、Cochrane图书馆、CINAHL、PsycINFO和EMBASE。共识别出1075项研究，由三位研究人员对34项全文研究进行了资格评估。17项研究符合纳入标准。本综述揭示了癌症恶病质护理实践和临床试验中的几个障碍。首先，包括护士在内的医疗保健专业人员在实践中面临个人障碍（对诊断和管理的理解和技能不足）和环境障碍（缺乏标准化筛查工具或治疗方案、与其他专业协作困难以及人力资源有限）。其次，关于护士主导的癌症恶病质干预措施的研究相对较少且目标各异，使得整合结果具有挑战性。最后，没有专门针对癌症恶病质的既定护士教育项目。本范围综述揭示了护理实践中的个人和环境障碍。此外，涉及肿瘤护理人员的癌症恶病质临床试验相对较少。护士继续教育应涵盖癌症恶病质，以提高未来肿瘤护理的质量。还需要规范易于日常评估并能引导干预措施的实用评估工具，并开展护士主导的多学科护理。
