The effectiveness of the Internet-based self-management program for cancer-related fatigue patients: a systematic review and meta-analysis

Abstract

Objective: To systematically investigate how fatigue, depression, anxiety, sleep quality, and life quality are influenced by the Internet-based self-management program (IBSMP) among cancer patients. Data sources: Eight databases (Cochrane Library, Ovid, Web of Science, Medline, Embase, Chinese biomedical database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang) were systematically searched from inception to January 2019. Methods: The aim of this study is to identify randomized controlled trials (RCTs) associated with the IBSMP among cancer-related fatigue (CRF) patients. Two reviewers independently screened 1128 records and selected 13 articles, including 1603 patients for inclusion. The quality of the evidence was assessed at the study level and at the outcome level. Results: The meta-analysis showed that the IBSMP was effective for ameliorating fatigue and related symptoms among cancer survivors (the Brief Fatigue Index, relative risk = 0.74, 95% confidence interval (CI; 0.69, 0.79), P < 0.01; the Cancer Fatigue Scale or the Multidimension Fatigue Scale, weighted mean difference = −10.15, 95% CI (−11.42, −8.89), P < 0.01; the Self-rating Anxiety scale, relative risk = 1.07, 95% CI (0.55, 2.05), P < 0.01; the Self-rating Depression scale, relative risk = 0.70, 95% CI (0.60, 0.81), P < 0.01; the Pittsburgh Sleep Quality Index, relative risk = 0.46, 95% CI (0.33, 0.62), P < 0.01; and the Function Assessment of Cancer Therapy—General scale or the Function Assessment of Cancer Therapy—Breast, weighted mean difference = 13.76, 95% CI (3.38, 24.14), P < 0.01.) Conclusion: This meta-analysis demonstrates that the IBSMP, as one of the rehabilitation forms, can reduce the incidence of fatigue, depression, and anxiety and improve sleep quality and life quality among CRF patients.

What is rehabilitation? An empirical investigation leading to an evidence-based description

“…• • Chronic obstructive pulmonary disease, 62 improving quality of life, reducing hospital admissions, but possibly increasing mortality; 63 • • Stroke, improving quality of life; 64 • • Fatigue in people with fatigue associated with cancer and its treatment. 65,66 The common components of successful community-based programmes 67 are also mostly achieved through education about: In summary, there is good evidence that practicing functional activities and undertaking cardiorespiratory exercise are both important interventions in any rehabilitation service. Education is also an important intervention, although its content is less well established; it probably always includes knowledge about the disease; its causes, prognosis, and treatments; and teaching skills in relation to self-management.…”

Patients’ Expectations of Physiotherapeutic Treatment for Long-Term Side Effects After Cancer: A Qualitative Study

“…A recent review found that internet-based programs are effective in reducing LTSE. 30 Maybe physiotherapist should be more aware of advising patients to seek information online in combination with their treatment. However, it is important to recommend specific homepages, otherwise patient's lack trust in information from the Internet.…”

Evaluation of online, publicly available cancer‐related educational and self‐management resources for symptom management

“…Learning symptom self‐management (SM), a process through which a patient engages in learned health behaviors and daily management of their illness, 6 can decrease symptom severity and improve quality of life 7,8 . As households are increasingly connected to the Internet, 9,10 many online education materials are available to support cancer patients in learning how to self‐manage symptoms 7 .…”

“…Learning symptom self‐management (SM), a process through which a patient engages in learned health behaviors and daily management of their illness, 6 can decrease symptom severity and improve quality of life 7,8 . As households are increasingly connected to the Internet, 9,10 many online education materials are available to support cancer patients in learning how to self‐manage symptoms 7 . Online resources are accessible to a larger population, including those who might otherwise not have direct access to a healthcare professional (HCP), 7,9 who prefer to address such issues independently rather than attending face‐to‐face support groups or workshops to learn these skills, 11 or whose medical care is being shifted to a telemedicine format in the context of the COVID‐19 pandemic 12 .…”

“…As households are increasingly connected to the Internet, 9,10 many online education materials are available to support cancer patients in learning how to self‐manage symptoms 7 . Online resources are accessible to a larger population, including those who might otherwise not have direct access to a healthcare professional (HCP), 7,9 who prefer to address such issues independently rather than attending face‐to‐face support groups or workshops to learn these skills, 11 or whose medical care is being shifted to a telemedicine format in the context of the COVID‐19 pandemic 12 . Though retrieving health information and patient education materials through the Internet has been shown to be effective in reducing healthcare system costs and improving patient outcomes, 7 such benefits can only be achieved if the resources are of high‐quality.…”