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Systematic Review and Meta-Analysis of Nonpharmacological Interventions for Fatigue in Children and Adolescents With Cancer

Authors

  • Chi-Wen Chang RN, PhD,

    1. Instructor, School of Nursing, Chang Gung University and Doctoral Candidate, School of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC
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  • Pei-Fan Mu RN, PhD,

    Corresponding author
    1. Professor and Deputy Academic Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC
    • Address correspondence to Pei-Fan Mu, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan, ROC; peifan@ym.edu.tw

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  • Shiann-Tarng Jou MD,

    1. Shiann-Tarng Jou, Assistant professor, Visiting Staff, Department of Pediatrics, Taiwan University Hospital, Taipei, Taiwan, ROC
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  • Tai-Tong Wong MD,

    1. Professor and Chief of NS Pediatrics, Veterans General Hospital, Taipei, Taiwan, ROC
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  • Yu-Chih Chen RN, PhD

    1. Director, Department of Nursing, Taipei Veterans General Hospital and Adjunct Associate Professor, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei Medical University and National Defense, Medical Center, Taiwan, ROC
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  • Special thanks are given to the National Science Council for funding and to the Taiwan Joanna Briggs Institute Collaborating Center for systematic review training and support.

ABSTRACT

Background

Fatigue is one of the most distressing and prevalent symptoms reported by pediatric oncology patients. With the increase in cancer survival rates, medical teams have focused on methods that control cancer-related fatigue in children during the disease and its treatment in order to increase the quality of life for these patients.

Aim

The objective of this systematic review was to synthesize the best available evidence concerning the effectiveness of nonpharmacological interventions for fatigue in children and adolescents with cancer.

Methods

The search strategy was designed to retrieve studies published between 1960 and 2010 in either English or Chinese. This review included randomized controlled trials and quasi-experimental studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments.

Results

The review included six studies, and the meta-analysis revealed a statistically significant effect of exercise interventions in reducing general fatigue (effect size = –0.76; 95% CI [–1.35, –0.17]) in children and adolescents with cancer.

Conclusions and Implications

The review provides an evidence-based guide to future priorities for clinical practice. Exercise interventions could reduce the levels of general fatigue in children aged 6–18 years. In particular, exercise interventions for fatigue are feasible and safe.

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