Effectiveness of nurse-led interventions on self-care behaviors of patients living with cancer: A systematic review

Abstract

<p><strong>Purpose: </strong>To synthesize evidence on nurse-led interventions for improving self-care behaviors in patients living with cancer, to examine methods and tools used to measure the effectiveness of nurse-led interventions, and to evaluate the impact of nurse-led interventions on self-care behavior outcomes.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic review was conducted using the MEDLINE, PsycINFO, CINAHL, and Cochrane Library databases, covering the period from January 2014 to March 2025. To ensure transparency, the review protocol was registered on PROSPERO. The study selection, data extraction, and synthesis were performed independently by two reviewers. The screening of studies was managed using Rayyan software. A deductive approach was followed to identify self-care behaviors from the selected studies, using the definition of self-care behaviors as outlined in Riegel's Middle-Range Theory of Self-Care.</p><p><strong>Results: </strong>This review included nine nurse-led intervention studies that aimed to improve self-care behaviors in patients living with cancer. Following Riegel's framework, several self-care behaviors were identified under three domains that are: self-care maintenance, monitoring, and management. These behaviors included medication adherence; dietary adjustments; engagement in exercise, sleep, and rest routines; symptom monitoring; and seeking advice when needed. This review identified several key features of nurse-led interventions, which contributed to the improvements in self-care behaviors and health outcomes. Teaching and education, skills-building and motivational coaching, continuous support, an individualized approach, family involvement, and pragmatic feasibility of the implemented strategies were the key features of the nurse-led interventions that supported the self-care behaviors of patients living with cancer. Most of the interventions were delivered face-to-face. A range of assessment tools were used to evaluate the outcomes of the interventions.</p><p><strong>Conclusion: </strong>Nurse-led interventions demonstrated a positive influence on self-care behaviors and health outcomes, including improved medication adherence, reduction in pain, fatigue and symptom burden, enhanced physical functioning, and better quality of life. Interventions appeared to be effective when they incorporated multiple strategies and targeted specific symptoms or behaviors.</p>