Background: The symptom cluster of cancer-related fatigue-sleep disturbance-depression (F-S-D) is common among breast cancer (BC) patients undergoing chemotherapy. Given the coexisting nature and synergistic effect of this symptom cluster, interventions for managing it are expected to benefit patient outcomes.
Objectives: The aims of this study were to examine the effectiveness and identify the essential components of interventions used to manage the F-S-D and quality of life (QOL) in BC patients undergoing chemotherapy.
Methods: A systematic review was performed in March 2020 through 7 electronic databases. Relevant studies were assessed using the inclusion criteria. The level of evidence was assessed using the Cochrane risk-of-bias tool. The results were summarized and synthesized in narrative forms.
Results: Sixteen randomized controlled trials were included. Results showed that bright light therapy, acupressure, and psychological nursing interventions were useful in managing F-S-D in BC patients. Exercise and diet counseling alleviated F-D, whereas stress management and a health promotion program alleviated S-D. Bright light therapy, exercise, diet counseling, and psychological nursing interventions enhanced the QOL of these patients.
Conclusion: Interventions that could alleviate F-S, F-D, S-D, and F-S-D in BC patients and enhance their QOL were identified. Future studies should investigate the effects of evidence-based multimodal interventions that integrate psychological support, education on the management of chemotherapy side effects, and diet counseling and exercise on F-S-D in and reduced QOL of BC patients undergoing chemotherapy.
Implications for practice: Nurses act as patient advocates, and the development of evidence-based interventions for managing F-S-D and QOL is significant to nursing practice.
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