The effectiveness of nurse-led care in supporting self-management in patients with cancer: A systematic review

Aims and objectives: To determine the impact of nurse-led follow-up care supporting self-management of people who have had or have cancer. Background: Cancer care is evolving towards enabling people to self-manage the impact of cancer, treatment and overall care on their quality of life (QoL), self-efficacy and distress. Design: A systematic review following Joanna Briggs Institution (JBI) guidance and reported in accordance with the PRISMA statement was undertaken. Methods: Four databases were searched, OVID Medline, CINAHL, PsychINFO and Embase. Quantitative randomised control trials with people who have or have had cancer accessing nurse-led care or nurse-led intervention, undertaken within secondary care were included. Narrative synthesis was undertaken due to heterogeneity of measures used and time points of assessment. Results: Seven papers were included in the final review, all meeting moderate to high-quality appraisal. Only one study found an impact of nurse-led care on all three factors under investigation, with a further two studies finding an effect on distress. The remaining studies did not find an impact of the intervention. Conclusion: Clinical Nurse Specialists are well placed to provide follow-up care for people with cancer, but in relation to QoL, self-efficacy and distress, there is limited evidence of effectiveness of nurse-led interventions. Public or patient contribution: This systematic review did not have any public or patient contribution. Relevance to clinical practice: Cancer care is moving to a chronic care, self-management model. Clinical nurse specialists are well placed to innovate interventions that assist people with cancer to self-manage.