Self-management can improve clinical and psychosocial outcomes in cancer survivors. Which intervention characteristics and components are beneficial is unclear, hindering implementation into practice. We systematically searched six databases from inception to 17 November 2021 for studies evaluating self-management interventions for adult cancer survivors post-treatment. Independent reviewers screened for eligibility. Data extraction included population and study characteristics, intervention characteristics (TIDieR) and components (PRISMS), (associations with) quality of life (QoL), self-efficacy, and economic outcomes. Study quality was appraised, and narrative synthesis was conducted. We identified 53 papers reporting 32 interventions. Studies had varying quality. They were most often randomised controlled trials (n = 20), targeted at survivors of breast (n = 10), prostate (n = 7), or mixed cancers (n = 11). Intervention characteristics (e.g., provider, location) varied considerably. On average, five (range 1–10) self-management components were delivered, mostly “Information about condition and its management” (n = 26). Twenty-two studies reported significant QoL improvements (6 also reported significant self-efficacy improvements); these were associated most consistently with combined individual and group delivery. Economic evaluations were limited and inconclusive. Self-management interventions showed promise for improving QoL, but study quality was variable, with substantial heterogeneity in intervention characteristics and components. By identifying what to adapt from existing interventions, these findings can inform development and implementation of self-management interventions in cancer.
自我管理能够改善癌症幸存者的临床与心理社会结局，但何种干预特征与构成要素具有积极作用尚不明确，这阻碍了其在实践中的应用。我们系统检索了自建库至2021年11月17日期间六大数据库中评估治疗后成年癌症幸存者自我管理干预措施的研究。由独立评审员进行资格筛选。数据提取内容包括：人群与研究特征、干预特征（基于TIDieR框架）与构成要素（基于PRISMS框架）、生活质量、自我效能感及经济性结局指标（及其关联性）。研究质量经评估后进行叙述性综合。最终纳入53篇文献，涉及32项干预方案。研究质量参差不齐，其中以随机对照试验为主（20项），干预对象主要为乳腺癌（10项）、前列腺癌（7项）或混合癌种（11项）幸存者。各项干预在实施者、场所等特征上存在显著差异。平均每项干预包含5个自我管理构成要素（范围1-10个），最常采用的要素为“疾病及其管理相关信息”（26项）。22项研究报告了生活质量的显著改善（其中6项同时报告自我效能感的显著提升），这种改善与个体化与团体化相结合的干预形式呈现最稳定的关联。经济性评估研究有限且结论不明确。自我管理干预在改善生活质量方面展现出潜力，但研究质量存在差异，且干预特征与构成要素具有高度异质性。通过明确现有干预中可借鉴的要素，本研究可为癌症自我管理干预方案的开发与实践转化提供依据。
肿瘤(癌症)患者之家