Effectiveness of e‐health based self‐management to improve cancer‐related fatigue, self‐efficacy and quality of life in cancer patients: Systematic review and meta‐analysis

• Published in: Journal of advanced nursing 2019-12, Vol.75 (12), p.3434-3447
• Main Authors: Xu, Anqi, Wang, Yinping, Wu, Xue
• Format: Article
• Language: English
• Subjects: Cancer; Clinical trials; Disease management; Efficacy; Evidence-based nursing; Fatigue; Health; Meta-analysis; neoplasms; Nursing; Online instruction; Patient education; Quality of life; Self-efficacy; self‐management; Systematic review; Telemedicine
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.14197

Aims To integrate the overall effect of e‐health based self‐management on cancer‐related fatigue (CRF), self‐efficacy, and quality of life (QOL) among adult cancer patients. Design A systematic review and meta‐analysis of randomized controlled trials. Data sources We researched PubMed, Cumulative Index Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Web of Science and Embase up to 14 July 2019. Review Methods We conducted the review with the Cochrane Handbook (version 5.1.0) and measured the quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation criteria. Results Literature searching identified 15 trials with a total of 2,337 participants. Integrated results analysis of e‐health based self‐management demonstrated a statistically significant but small effect on CRF and self‐efficacy, but no statistically significant improvement on the QOL. Meanwhile, subgroup analysis indicated that e‐health based self‐management had a larger effect on fatigue compared with usual care/waiting list control. Conclusion E‐health based self‐management is effective for CRF and self‐efficacy, but not the QOL. More high‐quality randomized control trials are warranted to confirm these conclusions. Impact Results showed e‐health could improve fatigue and self‐efficacy but not the QOL. Health providers could take into the various factors of e‐health interventions when providing telehealth service. Other researchers might be inspired by the current review before they begin a study about e‐health. 目的 在于整合基于电子健康的自我管理对成年癌症患者癌性疲劳(简称为“CRF”)、自我效能和生活质量(简称为“QOL”)的总体影响。 设计 随机对照试验的系统综述和荟萃分析。 资料来源 截至2019年7月14日,我们研究了PubMed、Cumulative Index Nursing and Allied Health Literature、Cochrane Central Register of Controlled Trials、Web of Science和Embase。 综述方法 我们使用 Cochrane Handbook(版本5.1.0)进行综述,并使用建议评估、开发和评估分级法(简称为“GRADE”)标准来衡量证据的质量。 结果 文献检索确定了15项试验,共有2337名研究对象。基于电子健康的自我管理综合结果分析显示,对癌性疲劳和自我效能的影响具有统计显著性和较小性,但对生活质量没有统计显著性改善。同时,亚组分析表明,与常规护理/等候名单管理相比,基于电子健康的自我管理对疲劳的影响更大。 结论 基于电子健康的自我管理对癌性疲劳和自我效能有效,但对生活质量无效。需要更多高质量的随机对照试验来证实这些结论。 影响 结果显示电子健康可以改善疲劳和自我效能,但不能改善生活质量。保健服务提供者在提供远程保健服务时,可以考虑电子保健干预措施的各种因素。其他研究人员在开始研究电子健康之前,可能会从当前综述得到启发。