Witziers Marijn, Looijmans Anne, Jia Ning, Hagedoorn Mariët
Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
J Cancer Surviv. 2025 Jul 18. doi: 10.1007/s11764-025-01866-6.
Cancer-related fatigue (CRF) is the most prevalent and disruptive side effect of cancer and its treatment, significantly impairing patients' quality of life. While guidelines mandate periodic screening, in-depth assessments, and non-pharmacological treatments for fatigue, the adherence of healthcare professionals (HCPs) to these guidelines is unknown. Therefore, this review aims to synthesize existing knowledge on HCPs' adherence to CRF guidelines.
A systematic review was conducted, encompassing searches across six databases and Google Scholar. Studies reporting on CRF management, barriers to CRF care experienced by HCPs, or interventions aimed at improving CRF management were included. A narrative synthesis approach was employed to analyze findings.
Of the 7039 identified publications, seventy-seven studies met the inclusion criteria. Findings reveal notable discrepancies between guideline recommendations and clinical practice. Specifically, fatigue screening was inconsistently performed across healthcare settings, comprehensive fatigue assessments were scarce, and pharmacological interventions were commonly used to alleviate fatigue. Barriers such as time constraints and insufficient knowledge hindered optimal CRF management.
Findings of this review suggest that HCPs do generally not adhere to clinical guidelines for fatigue management.
There is ample room to improve CRF management, with systematic changes essential to addressing barriers to effective fatigue management. As part of these changes, enhancing HCP education can help to frame CRF as a manageable, multifaceted symptom. These improvements will contribute to better fatigue communication, recognition, timely support, and a more coordinated approach to care for patients affected by this debilitating condition.
癌症相关疲劳（CRF）是癌症及其治疗中最普遍且具有破坏性的副作用，严重损害患者的生活质量。尽管指南要求对疲劳进行定期筛查、深入评估和非药物治疗，但医护人员（HCPs）对这些指南的遵循情况尚不清楚。因此，本综述旨在综合关于医护人员对CRF指南遵循情况的现有知识。
进行了一项系统综述，涵盖对六个数据库和谷歌学术的检索。纳入了报告CRF管理、医护人员在CRF护理中遇到的障碍或旨在改善CRF管理的干预措施的研究。采用叙述性综合方法分析研究结果。
在7039篇已识别的出版物中，77项研究符合纳入标准。研究结果显示指南建议与临床实践之间存在显著差异。具体而言，疲劳筛查在不同医疗环境中的执行不一致，全面的疲劳评估很少，并且药物干预常用于缓解疲劳。时间限制和知识不足等障碍阻碍了最佳的CRF管理。
本综述的结果表明，医护人员通常不遵循疲劳管理的临床指南。
改善CRF管理有很大空间，系统性变革对于解决有效疲劳管理的障碍至关重要。作为这些变革之一，加强医护人员教育有助于将CRF视为一种可管理的多方面症状。这些改进将有助于更好地沟通、识别疲劳，及时提供支持，并采用更协调的方法来护理受这种使人衰弱病症影响的患者。
