Zweers, D., de Graaf, E., & Teunissen, S.C. (2015). Non-pharmacological nurse-led interventions to manage anxiety in patients with advanced cancer: A systematic literature review. International Journal of Nursing Studies, 56, 102–113.
DOI Link
Purpose
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED; N (studies) = seven
- TOTAL PATIENTS INCLUDED IN REVIEW: 706
- SAMPLE RANGE ACROSS STUDIES: 24-189 patients
- KEY SAMPLE CHARACTERISTICS: A majority of patients were in the outpatient setting. Studies were published from 1999 to 2013.
Phase of Care and Clinical Applications
PHASE OF CARE: Multiple phases of care
APPLICATIONS: Palliative care
Results
Four of seven interventions were educational. In some studies, education was combined with telemonitoring or progressive muscle relaxation. Counseling and coaching as self-care strategies for monitoring symptoms were evident in two studies. Two studies focused on expressive writing, and focused narrative interview. One study compared aromatherapy with massage. Interventions were performed by nurses and research nurses, with or without training. Duration of interventions ranged from 1-3 contacts in one week to six months. Contacts were face-to-face or by telephone. None of the studies documented patient adherence to the interventions. The development of the interventions was limited to literature review. Two studies showed significant differences between the intervention and control group at six months (telemonitoring combined with education). One study did not show significance between the control and intervention groups at one week. A study of progressive muscle relaxation showed significance in anxiety at week 6 and week 12. No significant effect on anxiety was found between aromatherapy and massage. There was significantly decreased anxiety after each massage. This was also seen in a study that focused on narrative interview.
Conclusions
Although some of the studies described showed some significance, all had limitations. Studies are scarce; only seven met the inclusion criteria.
Limitations
Some studies had a high attrition rate. The authors defined several areas of bias including selection, performance, attrition, and reporting. There was limited information regarding development of interventions. There was not enough information on any one intervention to be able to clearly to implement it as evidence.
Nursing Implications
Evidence regarding nonpharmacologic nursing interventions for anxiety is scarce. More nursing research is indicated, including well-developed interventions.