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Table 1 Study and intervention characteristics

From: Effectiveness, structure, and content of nurse counseling in gynecologic oncology: a systematic review

Reference & country Study design Participants Interventions
Structure components
Content components Outcome measures
Variables – Measures
Time points Results Study qualitya Evidence levelb
Aktaş et al. 2014 [41]
Turkey
RCT
Repeated measures
Experimental
Patients with gynecological cancer
N = 70
Intervention – Home Care Service: n = 35
Attention control: n = 35
Age: M = 49
43% ovarian, 43% endometrial, 14% cervical cancer
Provider/receiver Nurse (not specified)/patients Disease Psychosocial symptoms Sexual satisfaction – Golombok Rust Inventory of Sexual Satisfaction (GRISS) T1: pre-surgery
T2: 12 weeks post-surgery
• Significant improvement in intervention group at T2 in overall sexual satisfaction (p = .001) and in its subscales ‘sexual non-communication’, ‘anorgasmia’, ‘avoidance’, ‘vaginismus’, ‘dissatisfaction’, and ‘non-sensuality’ (all p < .05)
• No significant improvement in the ‘infrequency of sexual contact’ subscale (p = .77)
Low 1c
Time frame Repeated consultations before, during, and after active treatment Treatment Psychosocial symptoms
Mode of delivery Face-to-face Symptom Management Symptom etiology; symptom prevention; symptom treatment
Format & setting Individual counseling; clinic & home
Materials Symptom-management guideline; individual care plans Resources Social network
Concepts Structured & tailored counseling
Chow et al. 2014 [42]
China
RCT
Mixed methods
Feasibility study
Repeated measures
Experimental
Patients newly diagnosed with gynecological cancer scheduled for surgery
N = 26
Intervention – psychoeducational program: n = 13
Attention control: n = 13
Age: M = 51
31% cervical, 54% uterine, 15% ovarian cancer
Provider/receiver Non-APN with academic education/patients Disease Etiology; physical and psychosocial symptoms Quality of life – Traditional Chinese Functional Assessment of Cancer Therapy-General
Sexual functioning – Sexual functioning-Vaginal changes Questionnaire
Uncertainty – Mishel’s Uncertainty in Illness Scale
Anxiety/depression – Hospital Anxiety & Depression Scale
Social support – Medical Outcomes Study Social Support Survey
T1: pre-surgery
T3: 8 weeks post-surgery
T3: 8 weeks post-surgery
T1: pre-surgery
T2: post-surgery
T3: 8 weeks post-surgery
• No significant group differences in overall quality of life and its ‘physical’, ‘functional’, ‘emotional’ and ‘social’ subscales, in sexual functioning, in overall uncertainty and its ‘ambiguity’, ‘complexity’, and ‘unpredictability’ subscales, in anxiety and depression, and in social support (all p > .05)
• Significant improvement at T2 in intervention group in the uncertainty subscale ‘inconsistency’ (p = .026)
Moderate 1c
Time frame Repeated, long consultations before, during, and after active treatment Treatment Therapeutic procedures; physical and psychosocial symptoms
Mode of delivery Face-to-face & phone Symptom Management Symptom prevention; symptom treatment
Format & setting Individual & group counseling; clinic
Materials no materials Resources Personal capabilities; social network; healthcare services
Concepts Structured & tailored; theoretical basis
Cox et al. 2008 [46]
United Kingdom
One-group pretest-posttest
Case series
Pre-experimental
Patients with ovarian cancer having completed chemotherapy
Telephone follow-up on chemotherapy symptom management: N = 56
Age: M = 62
Provider/receiver APN with academic education/patients Disease Etiology; diagnostic procedures Quality of life – FACT Ovarian (FACT O)
Patient experience and satisfaction –self-designed patient experience and satisfaction questionnaire
T1: after chemotherapy completion
T2: 10 months from baseline
• No significant improvement in overall quality of life and its ‘physical’, ‘functional’, ‘social’, and ‘symptoms’ subscales (all p > .05)
• Significant improvement in the ‘emotional’ quality of life subscale (p = .016)
• Patient satisfaction and experience high (M = 8.24, SD = 2.0) at T2 (no pretest scores provided)
Low 4c
Time frame Repeated, short consultations after active treatment Treatment Physical and psychosocial symptoms
Mode of delivery Phone Symptom Management Symptom etiology; symptom treatment
Format & setting Individual counseling
Materials Symptom-assessment tool; symptom-management guideline; leaflets Resources Personal capabilities; social network; healthcare services
Concepts Structured & tailored counseling; inter-disciplinary orientation
Donovan et al. 2014 [25]
USA
RCT
Waitlist-control
Pilot study
Repeated measures
Experimental
Patients with persistent or recurrent ovarian cancer
N = 65
Intervention – Web-based symptom management: n = 33
Control: n = 32
Age: M = 56
Provider/receiver Non-APN with academic education/patients Disease Physical and psychosocial symptoms Symptom outcomes – Symptom Representation Questionnaire (SQR) T1: pre-intervention
T2: 2 weeks post-intervention
T3: 6 weeks post-intervention
• Significant improvement of symptom distress over time (p = .037) and of symptom severity at T1 in intervention group (p = .058)
• No significant group differences in symptom consequences or symptom controllability (all p > .05)
• Patients highly satisfied with intervention and web-based delivery (Mdn not provided)
High 1c
Time frame Repeated consultations before, during, and after active treatment Treatment Physical and psychosocial symptoms
Mode of delivery Internet Symptom Management Symptom etiology; symptom assessment; goal setting & planning; symptom prevention/treatment; evaluation & modification
Format & setting Individual counseling Satisfaction with intervention – self-designed questionnaire T3: 6 weeks post-intervention
Materials Symptom-assessment tool; symptom-management guidelines; individual care plans
Concepts Structured & tailored; interdisciplinary orien-tation theoretical basis; Resources Personal capabilities; healthcare services
Liu et al. 2001 [48]
Taiwan
Posttest-only with nonequivalent comparison group
Observational-descriptive study
Repeated measures
Pre-experimental
Patients with cervical cancer who had radical hysterectomy
N = 20
Intervention I – Educational program for lower urinary tract self-care by a head nurse + written material: n = 11
Intervention II – Educational program for lower urinary tract self-care by a staff nurse: n = 9
Provider/receiver Intervention I & II: non-APN without academic education/patients Disease Intervention I & II: no content Knowledge about Foley care & bladder training – self-designed questionnaire T1: at discharge
T2: at readmission 2 weeks later
• Significant improvement of knowledge in intervention I at T1 (p = .004), but not at T2 (p = .71)
• No significant group differences at T2 in performance at home, urinalysis, or urine culture (all p > .05)
Moderate 4b
Time frame Intervention I & II: Repeated consultations during active treatment Treatment Intervention I & II: Physical symptoms
Mode of delivery Intervention I & II: face-to-face Symptom Management Intervention I & II: symptom assessment; symptom prevention; symptom treatment; evaluation & modif Home performance of Foley catheter self-care – self-designed questionnaire
Urinalysis, urine culture – laboratory records
T2: at readmission 2 weeks later
Format & setting Intervention I & II: individual; clinic
Materials Intervention I: leaflet
Intervention II: none
Concepts Intervention I & II: structured counseling Resources Intervention I & II: no content
Maughan et al. 2001 [26]
United Kingdom
RCT
Mixed methods
Repeated measures
Experimental
Patients with gynecological cancer and major pelvic surgery
N = 36
Intervention – Clinical Nurse Specialist intervention: n = 19
Control: n = 17
Age: M = 50
Provider/receiver APN with academic education/patients, families Disease Not specified Quality of life – European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) T1: pre-surgery
T2: 6 weeks post-surgery
T3: 12 weeks post-surgery
T4: 14 weeks post-surgery
T5: 24 weeks post-surgery
• Significant improvement in overall quality of life (p = .04) in the intervention group
• No significant group differences in the ‘physical’, ‘cognitive’, ‘emotional’, ‘social’, and ‘sexual’ quality of life subscales, as well as in sexual functioning (all p > .05)
Moderate 1c
Time frame Repeated consultations before, during, and after active treatment Treatment Therapeutic procedures; psycho-social symptoms
Mode of delivery Face-to-face Symptom Management Symptom etiology; symptom prevention; symptom treatment
Format & setting Individual counseling; clinic & home
Materials Leaflets Resources Personal capabilities; social network; healthcare services Sexual functioning – Lasry Sexual Function Scale T3: 12 weeks post-surgery
T5: 24 weeks post-surgery
Concepts structured & tailored; interdisciplinary orientation
McCorkle et al. 2009 [43]
USA
RCT
Repeated measures
Experimental
Patients with ovarian cancer following surgery and scheduled for chemotherapy
N = 149
Intervention – Advanced Practice Nurse intervention + Psychiatric Consultation-Liaison Nurse (PCLN) for women with high distress: n = 74
Attention control: n = 75
Age: M = 60
Provider/receiver APN with academic education/patients, families Disease Physical & psychosocial symptoms Depression – Center for Epidemiological Studies-Depression Scale (CES-D)
Uncertainty – Ambiguity subscale of the Mishel Uncertainty in Illness Scale (MUIS)
Symptom distress – Symptom Distress Scale (SDS)
Overall quality of life – Short-Form Health Survey (SF-12)
T1: 24-48 h post-surgery
T2: 1 month post-surgery
T3: 3 months post-surgery
T4: 6 months post-surgery
• Significant improvement of uncertainty concerning ambiguity (p = .018), symptom distress (p < .001), ‘physical’ and ‘cognitive’ quality of life subscales (all p < .001) over time in intervention group
• No significant group differences over time in overall quality of life and depression (all p > .05)
High 1c
Time frame Repeated consultations during and after active treatment Treatment Decision-making; physical & psycho-social symptoms
Mode of delivery Face-to-face & phone Symptom Management Symptom etiology; symptom assessment; goal setting & planning; symptom prevention, symptom treatment; evaluation & modification of strategies
Format & setting Individual counseling; clinic & home
Materials Symptom-assessment tool; symptom-management guideline; individual care plan
Concepts Structured & tailored counseling; interdisciplinary orientation; theoretical basis Resources Social network; healthcare services
McCorkle et al. 2011 [44]
USA
Same study like McCorkle et al. 2009 [43] N = 149
Intervention: n = 74
Attention control: n = 75
Age: M = 61
Same structure and content like in McCorkle et al. 2009 [43] Healthcare utilization – self-designed patient questionnaire, review of medical records T1: pre-surgery
T2: 6 weeks post-surgery
• Significant less primary care visits in intervention group (p < .001)
• No significant group differences in hospitalizations, oncology outpatient visits, and emergency room visits (all p > .05)
High 1c
Nolte et al. 2006 [45]
USA
RCT
Mixed methods
Repeated measures
Multicenter
Experimental
Patients with gynecologic cancer and chemotherapy-induced alopecia
N = 136
Intervention I – standard counseling: n = 68
Intervention II – standard counseling + videotape: n = 68
Age: M = 58
Ovarian, uterine, and cervical cancer
Provider/receiver Intervention I & II: Nurse (not specified)/patients Disease Intervention I & II: no content Body image & self-esteem – Body Cathexis/Self-Cathexis Scale (BCSCS) T1: before chemotherapy cycle 1
T2: before chemotherapy cycle 3
T3: after chemotherapy cycle 4
• No significant group differences in body image and self-esteem (all p > .05) Moderate 1c
Time frame Intervention I & II: One-time consultation before active treatment Treatment Intervention I & II: physical symptoms
Mode of delivery Intervention I & II: face-to-face Symptom Management Intervention I & II: symptom etiology; symptom treatment
Format & setting Intervention I & II: individual counseling; clinic
Materials Intervention I & II: Symptom-management guideline
Intervention II: video
Resources Intervention I & II: healthcare services
Concepts Intervention I & II: structured counseling; theoretical basis   
So et al. 2006 [47]
China
One-group pretest-posttest
Case series –
Patients with cervical cancer receiving brachytherapy Provider/receiver Nurse (not specified)/patients, families Disease No content Knowledge & attitudes regarding vaginal douching – self-designed
questionnaire
T1: presumably 1–2 weeks before
brachytherapy
T2: presumably 1–2 weeks before brachytherapy
T3: admission day brachytherapy
• Significant improvement of knowledge from pre-intervention to T2 and from pre-intervention to T3 (p < .001)
• Significant improvement of attitudes towards self-care from pre-intervention to T2 (p < .001), but not from pre-intervention to T3 (p > .05)
Moderate 4c
Treatment Physical symptoms
  repeated measures
Pre-experimental
Education program on vaginal douching: N = 30 Time frame One-time, long consultation before active treatment Symptom Management Symptom etiology; symptom assessment, symptom prevention; symptom treatment
Mode of delivery Face-to-face
Format & setting Individual counseling (presumably); clinic
Concepts Structured & tailored counseling Resources No content
  1. RCT randomized controlled trial, M mean, p p-value
  2. aLow methodological quality refers to total quality scores ranging from 0 to 49%; Moderate methodological quality refers to total quality scores ranging from 50 to 79%; high methodological quality refers to total quality scores ranging from 80 to 100%
  3. bLevel 1 refers to experimental designs, level 2 to quasi-experimental designs, level 3 to observational-analytic designs, level 4 to observational-descriptive studies, and level 5 to expert opinion and bench research [33]