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. 2023 Apr;29(2):111-127.
doi: 10.4094/chnr.2023.29.2.111. Epub 2023 Apr 30.

Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis

Kyung-Ah Kang  1 , Suk Jung Han  1 , Jiyoung Chun  2 , Hyun-Yong Kim  3 , Yerin Oh  4 , Heejin Yoon  4
Affiliations

Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis

Kyung-Ah Kang et al. Child Health Nurs Res. 2023 Apr.

Abstract

Purpose: This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS).

Methods: Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software.

Results: Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance.

Conclusion: Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

Keywords: Cancer survivors; Healthy lifestyle; Meta-analysis; Systematic review.

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Conflict of interest statement

Conflict of interest

No existing or potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
PRISMA flowchart of database search results on healthy lifestyle interventions for childhood and adolescent cancer survivors. RCT, randomized controlled trials.
Figure 2.
Figure 2.
Risk of bias graph of quality assessment. D1, randomization process; D2, deviations from the intended intervention; D3, missing outcome data; D4, measurement of the outcome; D5, selection of the reported result.
Figure 3.
Figure 3.
Forest plots of effect size and 95% CI of meta-analysis on healthy lifestyle interventions for childhood and adolescent cancer survivors (17 studies). CI, confidence interval; IV, inverse variance; SD, standard deviation.
Figure 4.
Figure 4.
Funnel plots of effect sizes for seven outcomes of the meta-analysis on healthy lifestyle interventions for childhood and adolescent cancer survivors (17 studies). BMI, body mass index.
See this image and copyright information in PMC

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