Exploration of the role of specialist nurses in the care of women with gynaecological cancer: a systematic review

Abstract

Aim and objective: To evaluate the role and interventions used by specialist nurses in caring for women with gynaecological cancer.

Background: Evidence evaluating the efficacy of specialist nurses in the gynaecological-oncology setting is limited and fragmented.

Design: Systematic review including both randomised controlled trials and nonrandomised studies.

Methods: Nine major databases were accessed from their date of inception to April 2013 with search results limited to publications from 1993-2013. Inclusion criteria were applied to select studies for review. Studies were critically appraised and assessment of the risk of bias performed. Data were extracted and compiled, with a narrative analysis undertaken.

Results: Nine studies (six randomised controlled trials and three nonrandomised studies) testing interventions by specialist nurses in the gynaecological-oncology setting were included in the systematic review. Results for the randomised controlled trials and nonrandomised studies were reported separately to enable distinction between evidence levels. Risk of bias assessment revealed that the quality of the randomised controlled trials was mixed and highlighted the inherent flaws of nonrandomised study designs. Studies varied greatly in the type of intervention provided and the tools used to measure outcomes, contributing to mixed results. The review demonstrated some positive effects of interventions by specialist nurses for women with gynaecological cancer, although these must viewed in conjunction with the assessment of evidence quality.

Conclusions: This systematic review has contributed to our understanding of the patient-centred aspects of the specialist nurse role in the gynaecological-oncology setting and further research is required to evaluate the role overall.

Relevance to clinical practice: The review indicates that interventions that either encompassed all domains of care, involved telephone contact or were executed between diagnosis and the completion of treatment were the most successful.

Keywords: cervical cancer; nursing interventions; oncology; ovarian cancer; patient satisfaction; psychological outcomes; quality of life; uterine cancer.