Self-management support for cancer-related fatigue: A systematic review.

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Publisher: Elsevier B.V.
Document Type: Report
Length: 553 words

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Keywords Cancer survivors; Cancer-related fatigue; Implementation; Survivorship; Self-management; Taxonomy Abstract Objectives To describe and examine the theories, components, and effectiveness of self-management support interventions for individuals experiencing cancer-related fatigue. Methods A systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. CINAHL, PubMed, Cochrane CENTRAL, and EMBASE were searched (from inception to June 2021) for randomised controlled trials examining self-management support interventions for managing cancer-related fatigue. Data were screened, extracted, and appraised by two authors. Data extraction was guided by the Self-management Support Taxonomy (i.e., a modified version of the Practical Reviews in Self-Management Support Taxonomy tailored to cancer). The Revised Cochrane Risk of Bias tool was used for study appraisal. A critical narrative synthesis was conducted. Results Fifty-one papers representing 50 different studies (n = 7383) were identified. Most interventions were delivered post-treatment (40%) using in-person (i.e., 'face-to-face') encounters (40%), and were facilitated by health professionals (62%). A range of intervention approaches and self-management support strategies were used across studies. The average number of Self-management Support Taxonomy components used across studies was 6.1 (of 14). Thirty-one studies (62%) described a specific behavior change theory to guide their self-management support intervention development. Twenty-nine studies (n = 29/50; 58%) reported a positive intervention effect for fatigue immediately post-intervention. Of these 29 studies, 10 (34%) reported at least one sustained positive effect on fatigue over follow-up periods between two and 12 months. Conclusions Self-management support that is delivered after cancer treatment, facilitated by health professionals, and incorporating at least one in-person contact appears to produce the most favourable fatigue and behavioral outcomes. However, further work is needed to better understand how individual self-management support strategies and the application of a behavioral theory influence behavior change. Program developers should guide self-management support with a behavioral theory, and describe their theory application in intervention development, implementation, and evaluation; ensure facilitators receive adequate support training; and seek the delivery preferences of cancer survivors. Future research should incorporate adequate follow-up to sufficiently evaluate the impact of programs on cancer-related fatigue and associated self-management behaviors. Findings from this review are relevant to all healthcare professionals, but are of most relevance to nurses as the largest cancer care workforce with a key role in delivering self-management support. Abbreviations CRF, cancer-related fatigue Author Affiliation: (a) Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia 5042, Australia (b) Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia (c) Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia (d) School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia (e) School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia 6027, Australia (f) Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia 6160, Australia (g) Nutrition and Dietetics Research Group, Bond University, Robina, Queensland 4226, Australia * Corresponding author at: Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia 5042, Australia. Article History: Received 20 September 2021; Revised 14 January 2022; Accepted 10 February 2022 (footnote) Protocol registration ID: CRD42020207121 Byline: Oluwaseyifunmi Andi Agbejule [andi.agbejule@flinders.edu.au] (a,b,c,*), Nicolas H. Hart (a,b,c,e,f), Stuart Ekberg (d), Megan Crichton (a,c,g), Raymond Javan Chan (a,b,c)

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Gale Document Number: GALE|A700885971