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SYSTEMATIC REVIEW PROTOCOLS

The use of non-pharmacological nursing interventions on the comfort of cancer patients: A comprehensive systematic review protocol

Apóstolo, João RN, PhD; Mendes, Aida RN, PhD; Bath-Hextall, Fiona BSc, PhD; Rodrigues, Rogério RN, PhD; Santos, José RN, PhD; Cardoso, Daniela RN

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JBI Database of Systematic Reviews and Implementation Reports: February 2013 - Volume 11 - Issue 2 - p 372-388
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Abstract

Inclusion criteria

Types of participants

This review will consider studies that include cancer patients:

  1. adult patients aged 18 years and older
  2. patients receiving or not receiving pharmacological treatment
  3. patients with any type or stage of cancer

Types of intervention(s)/phenomena of interest

Quantitative

This review will consider studies that use non-pharmacological interventions for cancer patients which are implemented by nurses compared to usual care. These interventions may include, but not be limited to, guided imagery, relaxation, therapeutic touch, therapeutic humor, and massage.

Qualitative

This component of the review will consider studies that include the following phenomena of interest: the experiences of comfort by patients undergoing non-pharmacological nursing interventions in ambulatory care and hospital care.

Types of outcomes

Quantitative outcomes

This review will consider studies that include the outcome “comfort” or another outcome related to this concept, measured by any comfort, pain, anxiety, depression, stress and fatigue scale.

Types of studies

Quantitative

This review will consider any experimental study design, including randomized controlled trials, non-randomized controlled trials, or other quasi-experimental studies, including before and after studies for inclusion.

Qualitative

This review will consider any interpretive studies concerning the experiences of cancer patients regarding comfort undergoing non-pharmacologic nursing interventions. Studies may include, but will not be limited to, designs such as phenomenology, grounded theory and ethnography.

Search strategy

The search strategy aims to find published and unpublished studies. A three-step search strategy will be used in this review. An initial limited search of MEDLINE and CINAHL will be undertaken, followed by the analysis of text words in the titles and abstracts, and of the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all databases included. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published in English, Spanish and Portuguese will be considered for inclusion in this review. Studies published in any year will be considered for inclusion in this review in order to cover a significant time span.

The databases to be searched include:

Academic Search Complete

CINAHL Plus with Full Text

MEDLINE with Full Text

Cochrane Central Register of Controlled Trials

LILACS

Embase

Scopus

Library, Information Science & Technology Abstracts

Nursing & Allied Health Collection: Comprehensive

MedicLatina

Scielo - Scientific Electronic Library Online

The search for unpublished studies will include:

Agency for Healthcare Research and Quality (AHRQ)

‘Grey Literature Report’ from New York Academy of Medicine

Mednar

Scirus.com website

National Library of Australia's Trove service

ProQuest - Nursing and Allied Health Source Dissertations

Banco de teses da CAPES (www.capes.gov.br)

RCAAP - Repositório Científico de Acesso Aberto de Portugal

Assessment of methodological quality

Quantitative

Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Qualitative

Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Data collection

Quantitative

Data will be extracted from papers included in the review independently by two reviewers, using standardized data extraction tools from the JBI-MAStARI (Appendix II). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Qualitative

Data will be extracted from papers included in the review independently by two reviewers, using standardized data extraction tools from the JBI-QARI (Appendix II). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Data synthesis

Quantitative

Quantitative data will, where possible, be pooled in statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated. Heterogeneity will be assessed statistically using the standard Chi-square. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate.

Qualitative

Qualitative data will, where possible, be pooled using the JBI-QARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings (Level 1 findings) rated according to their quality, and categorizing these findings on the basis of similarity in meaning (Level 2 findings). These categories will be then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings (Level 3 findings) that will be used as a basis for evidence-based practice.

Conflicts of interest

There are no conflicts of interest.

Acknowledgements

The authors thank the support provided by Health Sciences Research Unit - Nursing (UICISA-E), hosted by the Nursing School of Coimbra (ESEnfC).

References

[1] World Health Organization. Are the number of cancer cases increasing or decreasing in the world? [Web page] 2008 [updated 2012; cited 2012 20 Jul]; Available from: http://www.who.int/features/qa/15/en/index.html (2008)
    [2] Apóstolo J, Capela R, Castro I. Suffering and Comfort in Portuguese Cancer Patients. In: Sebastian M, Ninan N, Elias E, Gandhi M. Nanomedicine and Cancer Therapies, Recent Advances in Nanoscience and Nanotechnology. Apple Academic Press, Point Pleasant, NJ 08742 USA. 2 (13), 2012. 185 - 193, ISBN/ISSN: 978-1-926895-18-5
      [3] Lambing A, Markey C, Neslund-Dudas C, Bricker L. Completing a Life: Comfort Level and Ease of Use of a CD-ROM Among Seriously Ill Patients. Oncology Nursing Forum [serial on the Internet]. 2006 [cited 2012 Sep 5]; 33(5): 999-1006. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009281143&site=ehost-live.
        [4] León-Pizarro C, Gich I, Barthe E, Rovirosa A, Farrús B, Casas F, Verger E, Biete A, Craven-Bartle J, Sierra J, Arcusa A. A randomized trial of the effect of training in relaxation and guided imagery techniques in improving psychological and quality-of-life indices for gynecologic and breast brachytherapy patients. Psycho-Oncology [serial on the Internet]. 2007 [cited 2012 Sep 5]; 16(11): 971-979. Available from: http://onlinelibrary.wiley.com/doi/10.1002/pon.1171/pdf.
          [5] Catlin A, Taylor-Ford R. Investigation of Standard Care Versus Sham Reiki Placebo Versus Actual Reiki Therapy to Enhance Comfort and Well-Being in a Chemotherapy Infusion Center. Oncology Nursing Forum [serial on the Internet]. 2011 [cited 2012 Sep 5]; 38(3): 212-20. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2011029311&site=ehost-live.
            [6] Apóstolo J, Kolcaba K. The Effects of Guided Imagery on Comfort, Depression, Anxiety, and Stress of Psychiatric Inpatients with Depressive Disorders. Archives of Psychiatric Nursing [serial on the Internet]. 2009 [cited 2012 Jul 20]; 23(6): 403-411. Available from: http://www.sciencedirect.com/science/article/pii/S0883941708002045.
              [7] Bottorff J. The lived experience of being comforted by a nurse. Phenomenology + Pedagogy [serial on the Internet]. 1991 [cited 2012 Jul 2]; 9: 237-252. Available from: http://ejournals.library.ualberta.ca/index.php/pandp/article/view/15180/12001.
                [8] Instituto de Lexicologia e Lexicografia da Academia das Ciências de Lisboa (Institute of Lexicology and Lexicography of the Lisbon Academy of Sciences). Dicionário da língua portuguesa contemporânea (Dictionary of contemporary Portuguese language). Lisboa: Editorial Verbo.2001.
                  [9] Apóstolo J. Comfort in nursing theories. Concept Analysis and Theoretical Meaning. Revista Referência [serial on the Internet]. 2009 [cited 2012 Jul 5]; 2(9): 61 - 67. Available from: http://www.esenfc.pt/rr/rr/index.php?id_website=3&d=1&target=DetalhesArtigo&id_artigo=2133&id_rev=4&id_edicao=26.
                    [10] Kolcaba K, Kolcaba R. An analysis of the concept of comfort. Journal of Advanced Nursing [serial on the Internet]. 1991 [cited 2012 Jul 10]; 16(11): 1301-1310. Available from: http://thecomfortline.com/files/pdfs/1991%20-%20Analysis%20Concept%20of%20Comfort.pdf.
                      [11] Howk C. Enfermagem Psicodinâmica (Psychodynamic nursing) (A. R. Albuquerque, Trad.). In Tomey A, Alligood M. (Eds.). Teóricas de Enfermagem e a sua Obra: Modelos e Teorias de Enfermagem (Nursing Theorists and Their Work). Loures: Lusociência. 2004. 423-444.
                        [12] Phillips K. Modelo da adaptação (A. R. Albuquerque, Trad.). In Tomey A, Alligood M. (Eds.). Teóricas de Enfermagem e a sua Obra: Modelos e Teorias de Enfermagem (Nursing Theorists and Their Work). Loures: Lusociência. 2004. 301-333.
                          [13] Leininger M. Transcultural nursing: Concepts theories, research and practices. 2 ed. New York: McGraw-Hill.1995.
                            [14] Watson J. Filosofía y Teoria de los cuidados humanos en enfermería de Watson. In J. Riehl-Sisca (Ed.). Modelos conceptuales de enfermería. Barcelona: Ediciones Doyma.1992. 179-192.
                              [15] Watson J. Enfermagem: Ciência humana e cuidar: uma teoria de enfermagem (Nursing: Human Science and Human Care: A Theory of Nursing). 1 ed. Loures: Lusociência.2002.
                                [16] Malinowski A, Stamler L. Comfort: Exploration of the concept in nursing. Journal of Advanced Nursing [serial on the Internet]. 2002 [cited 2012 Jul 10]; 39(6): 599-606. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2002157279&lang=pt-br&site=ehost-live.
                                  [17] Watson J. Le caring. Philosophie et science des soins infirmiers. Paris: Editions Seli Arslan.1988.
                                    [18] Morse J. An ethnoscientific analysis of comfort: A preliminary investigation. Nursing Papers. 1983 Spring; 15(1): 6-20.
                                      [19] Morse J, Bottorff J,Hutchinson S. The paradox of comfort. Nursing Research. 1995; 44(1): 14-19.
                                      [20] Morse J. On comfort and comforting. American Journal of Nursing. 2000; 100(9): 34-38.
                                      [21] Morse J. Comfort: The refocusing of nursing care. Clinical Nursing Research.1992; 1(1): 91-106.
                                      [22] Kolcaba K. A taxonomic structure for the concept comfort. IMAGE: Journal of Nursing Scholarship [serial on the Internet]. 1991 [cited 2012 Jul 14]; 23(4): 237-240. Available from: http://thecomfortline.com/files/pdfs/1991%20-%20Taxonomic%20Structure%20of%20Comfort%20Theory.pdf.
                                        [23] Kolcaba K. A theory of holistic comfort for nursing. Journal of Advanced Nursing [serial on the Internet]. 1994 [cited 2012 Jul 14]; 19(6): 1178-1184. Available from: http://thecomfortline.com/files/pdfs/1994%20-%20Holistic%20Comfort%20for%20Nursing.pdf.
                                          [24] Kolcaba K. Comfort theory and practice. A vision for holistic health care and research. New York: Springer.2003.
                                            [25] Kolcaba K. Comfort as process and product, merged in holistic nursing art. Journal of Holistic Nursing.1995; 13(2): 117-131.
                                            [26] Sloman R, Brown P, Aldana E, Chee E. The use of relaxation for the promotion of comfort and pain relief in persons with advanced cancer. Contemporary Nurse. 1994; 3(1): 6-12.
                                            [27] Roffe L, Schmidt K, Ernst E. A Systematic Review of Guided Imagery as an Adjuvant Cancer Therapy. Psycho-Oncology [serial on the Internet]. 2005 [cited 2012 Sep 8]; 14(8): 607-617. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009093456&lang=pt-br&site=ehost-live.
                                              [28] Barron A, Coakley A, Mahoney E. Promoting the integration of therapeutic touch in nursing practice on an inpatient oncology and bone marrow transplant unit. International Journal for Human Caring [serial on the Internet]. 2008 [cited 2012 Sep 10]; 12(2): 81-89. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009963981&lang=pt-br&site=ehost-live.
                                                [29] Jane S, Wilkie D, Gallucci B, Beaton R, Huang H. Effects of a Full-Body Massage on Pain Intensity, Anxiety, and Physiological Relaxation in Taiwanese Patients with Metastatic Bone Pain: A Pilot Study. Journal of Pain and Symptom Management [serial on the Internet]. 2009 [cited 2012 Sep 10]; 37(4): 754-763. Available from: http://www.sciencedirect.com/science/article/pii/S0885392408005617.
                                                  [30] Kelly A, Sullivan P, Fawcett J, Samarel N. Touch, Quiet Time, and Dialogue: Perceptions of Women With Breast Cancer. Oncology Nursing Forum [serial on the Internet]. 2004 [cited 2012 Sep 5]; 31(3): 625-631. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2004099233&lang=pt-br&site=ehost-live.

                                                    Appendix I: Appraisal instruments

                                                    QARI Appraisal instrument

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                                                    MAStARI Appraisal instrument

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                                                    Appendix II: Data extraction instruments

                                                    QARI data extraction instrument

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                                                    MAStARI data extraction instrument

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                                                    Keywords:

                                                    Initial English language keywords to be used will be: Comfort; nurs*; interven*; cancer; patient*

                                                    © 2013 by Lippincott williams & Wilkins, Inc.