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

Oluwaseyifunmi Andi Agbejule; Nicolas H Hart; Stuart Ekberg; Megan Crichton; Raymond Javan Chan

doi:10.1016/j.ijnurstu.2022.104206

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

Int J Nurs Stud. 2022 May:129:104206. doi: 10.1016/j.ijnurstu.2022.104206. Epub 2022 Feb 24.

Authors

Oluwaseyifunmi Andi Agbejule¹, Nicolas H Hart², Stuart Ekberg³, Megan Crichton⁴, Raymond Javan Chan⁵

Affiliations

¹ Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia 5042, Australia. Electronic address: andi.agbejule@flinders.edu.au.
² Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia 5042, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia 6027, Australia; Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia 6160, Australia.
³ School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia.
⁴ Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia 5042, Australia; Nutrition and Dietetics Research Group, Bond University, Robina, Queensland 4226, Australia.
⁵ Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia 5042, Australia.

PMID: 35279591
DOI: 10.1016/j.ijnurstu.2022.104206

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.

Keywords: Cancer survivors; Cancer-related fatigue; Implementation; Self-management; Survivorship; Taxonomy.

Publication types

Review
Systematic Review

MeSH terms

Fatigue / etiology
Fatigue / therapy
Health Personnel
Humans
Neoplasms* / complications
Neoplasms* / therapy
Self-Management*