title: Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue.
abstract: BACKGROUND
  Fatigue is among the most common and distressing symptoms experienced by cancer patients.
  
  
  OBJECTIVE
  This systematic review and meta-analysis evaluates the efficacy of psychological and activity-based interventions against cancer-related fatigue in cancer patients.
  
  
  METHODS
  MEDLINE, PsycINFO, and CINAHL.
  
  
  METHODS
  Randomized controlled trials of psychological and activity-based interventions involving adult cancer patients in which fatigue was an outcome were reviewed.
  
  
  METHODS
  Forty-one trials were reviewed and 30 were included in a meta-analysis.
  
  
  RESULTS
  Fifty percent of psychological trials and 44% of activity-based trials rated fair or better in quality yielded significant findings favoring the intervention condition. Meta-analysis yielded an overall effect size of 0.09 (95% CI = .02- .16) favoring nonpharmacological conditions. Further analysis indicated that effect sizes were significant for psychological interventions (d-sub(w) = .10, 95% CI = .02-.18) but not activity-based interventions (d-sub(w) = .05, 95% CI = -.08 - .19).
  
  
  CONCLUSIONS
  Findings provide limited support for use of nonpharmacological interventions to manage cancer-related fatigue. The lack of research with heightened fatigue as an eligibility criterion is a notable weakness of the existing evidence base.
authors.affiliation: Health Outcomes and Behavior Program, Moffitt Cancer Center and University of South Florida, 12902 Magnolia Drive, Tampa FL 33612, USA. paul.jacobsen@moffitt.org
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Donovan
authors.forename: Susan T
authors.initials: ST
authors.lastname: Vadaparampil
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
mesh_terms: D026241:Exercise Movement Techniques; D005221:Fatigue / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010353:Patient Education as Topic; D011613:Psychotherapy / Q000379:methods*; D012648:Self Care; D012657:Self-Help Groups; D012944:Social Support