Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management

The effect of self-designed metabolic equivalent exercises on cancer-related fatigue in patients with gastric cancer: A randomized controlled trial

AIMS

To investigate the effect of Self-designed Metabolic Equivalent Exercises (SMEE) on cancer-related fatigue in patients with gastric cancer.

METHODS

130 patients with gastric cancer admitted to Department of Oncology of a tertiary hospital in Shanghai were enrolled and assessed for eligibility. After excluding 1 patient who declined to participate, 129 eligible patients were randomly assigned into SMEE (n = 65) and control (n = 64) groups. The Revised Piper Fatigue Scale (RPFS) and EORTC QLQ-C30 Quality of Life Scale were used to measure cancer-caused fatigue and quality of life, respectively, in both groups at the first admission and after 3 months.

RESULTS

After excluding patients who did not receive allocated intervention due to medical (n = 3) and personal (n = 2) reasons, those who were lost to follow-up (n = 3), and those who had discontinued intervention (n = 2), 119 patients (64 in the SMEE group and 55 in the control group) were included for analysis. There were no statistically significant differences in the RPFS or QLQ-C30 score between the two groups at baseline. After 3 months, the total RPFS score of the SMEE group was significantly lower than that of the control group (2.86 ± 1.75 vs. 4.65 ± 1.29, p = 0.009), with significant improvements in affective meaning (0.83 ± 0.92 vs. 1.13 ± 0.77, p = 0.044) and sensory (0.70 ± 0.71 vs. 1.00 ± 0.54, p < 0.001) subscales; in the SMEE group, QLQ-C30 scores in somatic (2.00 ± 0.27 vs. 1.31 ± 0.26, p < 0.001), emotional (2.67 ± 0.58 vs. 2.07 ± 0.48, p < 0.001), and social (3.23 ± 0.58 vs. 1.64 ± 0.51, p < 0.001) functioning were significantly higher than those in the control group, with significant improvements in fatigue (p < 0.001), nausea/vomiting (p = 0.014), shortness of breath (p < 0.001), constipation (p < 0.001), and diarrhea (p = 0.001) dimensions.

CONCLUSION

The self-programmed metabolic equivalent manipulation as an exercise intervention could effectively reduce the degree of cancer-caused fatigue and improve quality of life in patients with gastric cancer.

Physical activity interventions for cancer-related fatigue: A scoping review of randomized controlled trials from a Nursing Science Precision Health Model perspective

BACKGROUND

The Nursing Science Precision Health (NSPH) Model has the potential to guide research on the development, testing, and targeting of interventions.

PURPOSE

This scoping review examines the relationship between physical activity (PA) and cancer-related fatigue (CRF) within the context of the NSPH Model.

METHODS

The Joanna Briggs Institute scoping review methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this review. We included randomized controlled trials in people with cancer that investigated PA interventions and measured change in CRF as an outcome.

DISCUSSION

A total of 181 studies met the eligibility criteria. Over 20 different instruments were used to measure CRF. The most common PA interventions were strength training (48%), walking (36%), cycling (26%), and yoga (15%). A limited number of studies reported phenotypic characteristics (32/181, 17%) or biomarkers (31/181, 17%) associated with CRF.

CONCLUSION

This scoping review identified the body of existing research exploring CRF and PA from a precision health perspective.

Top 10 Tips for Research Grant Writing: A Guide for Nurses and Allied Health Professionals

OBJECTIVES

Nurses and allied health professionals have traditionally received less of the health and medical competitive research funding pool compared with medical practitioners and basic scientists. This instructive article aims to facilitate greater success rates by providing top 10 tips on good grantsmanship, which may serve as a guide for clinician researchers with limited experience with successful grant applications.

DATA SOURCES

Expert advice was used to write this article.

CONCLUSION

A quality grant application requires considerable time and investment. The top 10 tips include: (1) understanding the grant scheme; (2) partnering with the right mentor; (3) assembling the best team; (4) providing a case for novelty, significance, and urgency; (5) maximizing feasibility, scientific quality, and innovations; (6) providing evidence and data to substantiate claims; (7) ensuring points of difference; (8) clarifying return on investment; (9) ensuring perfect presentation and formatting; and (10) incorporating critical feedback.

IMPLICATIONS FOR NURSING PRACTICE

Each grant scheme can have different focuses and selection criteria. However, these top tips can be used as a guide to consider in maximizing success for nurse-led and allied health led research.

The Effects of Transcutaneous Acupoint Electrical Stimulation on Cancer-related Fatigue and Negative Emotions in Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Transcutaneous electrical acupoint stimulation (TEAS) is a noninvasive and therapeutic technique that stimulated the acupoint by delivering electricity. Whether TEAS could relieve cancer-related fatigue (CRF), anxiety, and depression and improve the quality of life in cancer patients remains controversial. Thus, we conducted a thorough literature search of electronic Chinese and English databases for randomized controlled trials (RCTs) reporting the effect of CRF, anxiety, depression, and quality of life in cancer patients from inception to July 1st, 2021. The Cochrane Collaboration Risk of Bias criteria were used to assess the risk of bias for each included RCT. Continuous variables were analyzed using standardized mean difference (SMD) and 95% confidence interval (CI). A fixed-effects model was used for the meta-analysis of all outcomes. A total of nine RCTs with 924 cancer patients were included in this analysis, including 460 patients in the interventional group and 464 patients in the control group. We found that TEAS could significantly reduce CRF, depression, and anxiety (SWD = −0.83, 95% CI: −0.99 to −0.66, $P<0.05$ ) and improve the quality of life (SWD = −1.37, 95% CI: −2.34 to −0.40, $P<0.05$ ). The funnel plot analysis revealed no significant publication bias. We conclude that TEAS is beneficial for reducing CRF, depression, and anxiety and improving the quality of life of cancer patients, but additional high-quality evidence in the future is entailed to support this.

Impact of community-based exercise on fatigue in early breast cancer survivors: identifying potential determinants of change

BACKGROUND

Exercise has been shown to reduce fatigue in early breast cancer survivors (EBCS), though it is unclear if these results translate to community-based exercise settings. Mechanisms that influence changes in fatigue seen after exercise are also poorly understood. This study sought to evaluate the impact of community-based exercise and identify associations of fatigue in EBCS.

METHODS

Twenty-nine EBCS and 13 non-cancer controls (CON) enrolled. Pre/post-intervention measurements included measures of fitness/function, balance, and adherence/compliance as well as self-reported measures of fatigue, health-related quality of life (HRQOL), well-being, self-efficacy, and physical activity. Both groups participated in a supervised 16-week aerobic + resistance exercise intervention. A mixed model ANOVA and Cohen's D effect size assessed fatigue changes, and univariable linear regressions identified fatigue associations.

RESULTS

Fatigue improved for EBCS (- 2.6, Cohen's D = 0.51) but not CON (0.0, Cohen's D = 0.02); no interaction effect was observed. Post-intervention fatigue in EBCS was associated with better QOL (R² = 0.387; p < 0.01), depression (R² = 0.251; p < 0.01), self-efficacy, (R² = 0.453; p < 0.01), outcome expectations from exercise (R² = 0.254; p < 0.01), balance (R² = 0.167; p < 0.05), and the 6-minute walk test (R² = 0.193; p < 0.05). EBCS improvements in fatigue were associated with improvements in self-reported physical health (R² = 0.425; p < 0.01), depression (R² = 0.233; p < 0.01), pain (R² = 0.157; p < 0.05), outcome expectations from exercise (R² = 0.420; p < 0.01), and the 6-minute walk test (R² = 0.172; p < 0.05). Less fatigue in the CON group was shown be associated with better sleep quality (R² = 0.309; p < 0.05) and pain (R² = 0.259; p < 0.05).

CONCLUSION

Community-based exercise appears beneficial for alleviating fatigue in EBCS. These improvements may be driven by parallel improvements in psychosocial outcomes and objectively measured functional outcomes.