Professor, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Professor, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia; Professor, School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia; Professor, Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Garran, ACT, Australia; Professor, Robert Gordon University, Aberdeen, Scotland, UK.
Professor, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Professor, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia.
Semin Oncol Nurs. 2023 Jun;39(3):151353. doi: 10.1016/j.soncn.2022.151353. Epub 2022 Nov 23.
The aim of this umbrella systematic review was to critically synthesize unmet supportive care needs of people affected by cancer.
The Joanna Briggs Institute (JBI) umbrella review method provided an overall examination of the body of evidence that was available in relation to the unmet supportive care needs among people living with cancer. All qualitative, quantitative, and mixed methods reviews were included irrespective of review design. Electronic databases were searched using a wide range of search terms. All records were managed using the software package Endnote X21 and uploaded to Covidence systematic review software. Duplication of records were removed. A preselection eligibility criterion was applied to all records. Data extraction and methodological quality assessment was conducted independently by two reviewers, and a meta-level narrative synthesis conducted.
A total 30 systematic reviews were included representing a total of 666 publications globally. Irrespective of the type of cancer there were many commonalities in relation to the reported experiences of unmet supportive care needs, which therefore enables the development of targeted future clinical trials, clinical guidelines, and policy contribution. In descending order of frequency, the highest unmet supportive care needs were related to psychological/emotional (30 out of 30), health system/information (29 out of 30), interpersonal/intimacy (21 out of 30), social (20 out of 30), physical (19 out of 30), family (18 out of 30), practical (16 out of 30), daily living (10 out of 30), spiritual needs (8 out of 30), patient-clinician communication (8 out of 30), and cognitive needs (5 out of 30).
This umbrella review has underscored fundamental shortcomings in care delivery irrespective of the patient population and the type of cancer. People with cancer are continually reporting that their needs are not being met across many supportive care domains. It is time for change within the health care system and to full leverage multidisciplinary person-centered models of care to optimize recovery and survivorship experiences. In the meantime, policy makers and cancer care clinicians are encouraged to reflect on these findings to address individualized care needs.
本伞式系统评价的目的是批判性地综合癌症患者未满足的支持性护理需求。
乔安娜·布里格斯研究所（JBI）伞式审查方法对与癌症患者未满足的支持性护理需求相关的现有证据进行了全面检查。纳入了所有定性、定量和混合方法的综述，无论综述设计如何。使用广泛的搜索词搜索电子数据库。使用 Endnote X21 软件包管理所有记录，并将其上传到 Covidence 系统审查软件。删除重复记录。对所有记录应用了预选资格标准。数据提取和方法学质量评估由两名评审员独立进行，并进行了元水平叙述性综合。
共纳入 30 项系统评价，代表全球共 666 项出版物。无论癌症类型如何，报告的未满足支持性护理需求都有许多共同之处，因此能够为未来的临床试验、临床指南和政策制定提供有针对性的贡献。按频率降序排列，最高的未满足支持性护理需求与心理/情感（30 项中的 30 项）、卫生系统/信息（30 项中的 29 项）、人际关系/亲密关系（30 项中的 21 项）、社会（30 项中的 20 项）、身体（30 项中的 19 项）、家庭（30 项中的 18 项）、实际（30 项中的 16 项）、日常生活（30 项中的 10 项）、精神需求（30 项中的 8 项）、医患沟通（30 项中的 8 项）和认知需求（30 项中的 5 项）。
本伞式综述强调了无论患者群体和癌症类型如何，护理提供方面的基本不足。癌症患者不断报告说，他们在许多支持性护理领域的需求未得到满足。是时候在医疗保健系统中进行变革了，充分利用多学科以患者为中心的护理模式，以优化康复和生存体验。与此同时，鼓励政策制定者和癌症护理临床医生反思这些发现，以满足个性化的护理需求。
