Interventions for Managing a Symptom Cluster of Pain, Fatigue, and Sleep Disturbances During Cancer Survivorship: A Systematic Review

Abstract

Problem identification: More than 40% of cancer survivors experience a symptom cluster of pain, fatigue, and sleep disturbances, which can greatly reduce quality of life.

Literature search: A literature search was performed using CINAHL®, Google ScholarTM, PubMed®, PsycINFO®, and Web of Science. Articles included randomized controlled trials of interventions aimed at managing a symptom cluster of pain, fatigue, and sleep disturbances.

Data evaluation: 11 studies were assessed for quality, risk of bias, cancer type, sample size, intervention type, duration, and setting. For an intervention to be considered effective, the reduction of symptom severity or distress had to be statistically significant.

Synthesis: Data from the 11 studies were summarized. Four interventions were found to be effective in managing the symptom cluster, but evidence on long-term effectiveness was insufficient.

Implications for nursing: Oncology nurses can assess the patterns and characteristics of simultaneous symptoms experienced by cancer survivors and administer interventions to relieve symptom burden and improve quality of life.

Keywords: fatigue; intervention; pain; quality of life; sleep disturbances; survivorship; symptom cluster.