Song Hyun Jin, Seo Hyun-Ju, Choi Eun Jeong, Lee Ji Sung, Choi Yumi
Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, 32601, USA.
College of Nursing, Chungnam National University, 266 Munhwa-Ro, Jung-Gu, Daejeon, 35015, Republic of Korea.
J Cancer Surviv. 2024 Sep 6. doi: 10.1007/s11764-024-01661-9.
The increasing population of cancer survivors poses a significant challenge for healthcare systems globally, necessitating comprehensive post-treatment care to address diverse physical, psychological, and social needs.
This systematic review aims to synthesize and critically evaluate the current evidence concerning the unmet needs for nursing services among cancer survivors, spanning various dimensions of survivorship care.
A systematic search was conducted across major databases, including PubMed, CINAHL, and PsycINFO, to identify relevant studies investigating the unmet needs and health-related quality-of-life (HRQOL) of nursing services led by nurses among cancer survivors. The final search update was conducted in June 2024. Unmet needs dimensions were categorized by the biopsychosocial-spiritual framework.
Of the 9503 records searched, 18 studies were included. This review revealed mixed findings in the domains of unmet needs and interventions aimed at addressing them. While nurse-led interventions showed promise in addressing physical and daily living needs, outcomes related to psychological and emotional needs varied across studies. Additionally, nurse-led interventions were effective in addressing patient-clinician communication and health system/information needs, although statistical significance was not consistently observed. HRQOL assessments using general and cancer-specific measures yielded mixed findings.
Despite limitations of the risk of bias of included studies and weak study designs for evaluating nurse-led intervention effects for cancer survivors, the findings highlight the potential of nursing practice to significantly contribute to improving unmet needs of physical, psychological, and social perspectives and ultimately improving their HRQOL. However, the impact on the spiritual needs of nursing care services is limited by the low number of studies.
By providing comprehensive support and management, nursing practice can enhance post-treatment outcomes and HRQOL for cancer survivors, contributing to more patient-centered and effective care delivery. More rigorous research considering a biopsychosocial-spiritual perspective to help cancer survivors improve HRQOL is needed.
癌症幸存者数量不断增加，给全球医疗系统带来了重大挑战，因此需要全面的治疗后护理来满足各种身体、心理和社会需求。
本系统评价旨在综合并批判性地评估当前有关癌症幸存者护理服务未满足需求的证据，涵盖生存护理的各个方面。
在包括PubMed、CINAHL和PsycINFO在内的主要数据库中进行系统检索，以识别调查癌症幸存者中护士主导的护理服务未满足需求及健康相关生活质量（HRQOL）的相关研究。最终检索更新于2024年6月进行。未满足需求维度按照生物心理社会-精神框架进行分类。
在检索的9503条记录中，纳入了18项研究。本评价揭示了在未满足需求领域以及旨在解决这些需求的干预措施方面存在不同的研究结果。虽然护士主导的干预措施在满足身体和日常生活需求方面显示出前景，但不同研究中与心理和情感需求相关的结果各不相同。此外，护士主导的干预措施在解决患者与临床医生沟通及医疗系统/信息需求方面是有效的，尽管并非始终观察到统计学显著性。使用一般和癌症特异性指标进行的HRQOL评估得出了不同的研究结果。
尽管纳入研究存在偏倚风险且评估护士主导的癌症幸存者干预效果的研究设计薄弱，但研究结果凸显了护理实践在显著改善身体、心理和社会层面未满足需求并最终提高其HRQOL方面的潜力。然而，护理服务对精神需求的影响因研究数量较少而受到限制。
通过提供全面的支持和管理，护理实践可以改善癌症幸存者的治疗后结局和HRQOL，有助于提供更以患者为中心且有效的护理服务。需要开展更严谨的研究，从生物心理社会-精神角度帮助癌症幸存者改善HRQOL。
