A systematic review of the effectiveness of problem-solving approaches towards symptom management in cancer care.
OBJECTIVE
To investigate the evidence of problem-solving approach interventions on symptom management in cancer care.


BACKGROUND
Symptom-related problems are a common challenge in cancer care. The problem-solving approach is one strategy of cognitive behavioural therapy used to help patients with cancer self-manage their symptoms. However, no systematic review has investigated the effectiveness of this approach.


METHODS
Systematic review.


METHODS
A systematic search for intervention studies using randomised controlled designs, controlled clinical trial and quasi-experimental studies designs was conducted using the following electronic databases: EBSCO host, CINAHL (1991-2008), Medline (1975-2009), Electronic Periodical Services (Chinese) and Electronic Theses and Dissertations System (Taiwan).


RESULTS
Seven studies published in English between 1975-2009 were included in this systematic review. All studies were randomly assigned and almost all studies demonstrated the positive effects of a problem-solving approach in reducing symptomatic problems in the target participants. Varying protocols and qualities of methodological design (14% good, 43% fair and 43% poor) were found in this review.


CONCLUSIONS
This systematic review highlighted the potential of a problem-solving approach in the management of symptom problems in patients with cancer. However, more rigourous studies are needed and a better evaluation of the most effective problem-solving approach protocols is required.


CONCLUSIONS
Cancer care nurses should explore the use of problem-solving approach interventions in their practice as the evidence base suggests the value of this approach--but caution is needed in regard to the precise structure of the problem-solving approach protocol.
Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yun-Hsiang
YH
Lee
Piao-Yi
PY
Chiou
Pi-Hua
PH
Chang
Mark
M
Hayter
D005500:Follow-Up Studies; D006801:Humans; D009369:Neoplasms / Q000451:nursing* / Q000503:physiopathology; D011340:Problem Solving; D016896:Treatment Outcome