Rimmer Ben, Brown Morven C, Sotire Tumi, Beyer Fiona, Bolnykh Iakov, Balla Michelle, Richmond Catherine, Dutton Lizzie, Williams Sophie, Araújo-Soares Vera, Finch Tracy, Gallagher Pamela, Lewis Joanne, Burns Richéal, Sharp Linda
Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
Cancers (Basel). 2023 Dec 19;16(1):14. doi: 10.3390/cancers16010014.
Self-management can improve clinical and psychosocial outcomes in cancer survivors. Which intervention characteristics and components are beneficial is unclear, hindering implementation into practice. We systematically searched six databases from inception to 17 November 2021 for studies evaluating self-management interventions for adult cancer survivors post-treatment. Independent reviewers screened for eligibility. Data extraction included population and study characteristics, intervention characteristics (TIDieR) and components (PRISMS), (associations with) quality of life (QoL), self-efficacy, and economic outcomes. Study quality was appraised, and narrative synthesis was conducted. We identified 53 papers reporting 32 interventions. Studies had varying quality. They were most often randomised controlled trials (n = 20), targeted at survivors of breast (n = 10), prostate (n = 7), or mixed cancers (n = 11). Intervention characteristics (e.g., provider, location) varied considerably. On average, five (range 1-10) self-management components were delivered, mostly "" (n = 26). Twenty-two studies reported significant QoL improvements (6 also reported significant self-efficacy improvements); these were associated most consistently with combined individual and group delivery. Economic evaluations were limited and inconclusive. Self-management interventions showed promise for improving QoL, but study quality was variable, with substantial heterogeneity in intervention characteristics and components. By identifying what to adapt from existing interventions, these findings can inform development and implementation of self-management interventions in cancer.
自我管理可改善癌症幸存者的临床和心理社会结局。尚不清楚哪些干预特征和组成部分是有益的，这阻碍了其在实践中的实施。我们系统检索了6个数据库，涵盖从建库至2021年11月17日的研究，以评估针对成年癌症幸存者治疗后的自我管理干预措施。独立评审员筛选纳入标准。数据提取包括人群和研究特征、干预特征（TIDieR）和组成部分（PRISMS）、生活质量（QoL）、自我效能以及经济结局（的关联）。评估研究质量并进行叙述性综合分析。我们确定了53篇报告32项干预措施的论文。研究质量参差不齐。它们大多是随机对照试验（n = 20），针对乳腺癌（n = 10）、前列腺癌（n = 7）或混合癌症（n = 11）的幸存者。干预特征（如提供者、地点）差异很大。平均提供了5个（范围1 - 10）自我管理组成部分，大多是“”（n = 26）。22项研究报告生活质量有显著改善（6项还报告自我效能有显著改善）；这些改善最一致地与个体和团体相结合的提供方式相关。经济评估有限且尚无定论。自我管理干预措施显示出改善生活质量的前景，但研究质量参差不齐，干预特征和组成部分存在很大异质性。通过确定从现有干预措施中应调整的内容，这些发现可为癌症自我管理干预措施的开发和实施提供参考。
