Non-Pharmacological Interventions for Symptom Cluster Management in Women with Cancer: A Scoping Review of...

Women with cancer frequently experience co-occurring symptoms, including cancer-related fatigue, sleep disturbance, and psychological distress, which negatively impact quality of life. Despite the increasing use of non-pharmacological interventions, current approaches remain largely fragmented and predominantly target individual symptoms rather than symptom clusters, highlighting the urgent need for integrated, cluster-based intervention models in women's cancer care.

This scoping review aimed to map recent non-pharmacological interventions for symptom management in women with cancer and to examine the extent to which these interventions address co-occurring symptom clusters.

A scoping review was conducted following Arksey and O'Malley's framework and the Joanna Briggs Institute (JBI) guidance, and reported in accordance with PRISMA-ScR. A systematic search of PubMed, CINAHL, and Scopus identified studies published between January 2021 and December 2025. Eligible studies included experimental and quasi-experimental designs evaluating non-pharmacological interventions targeting fatigue, sleep disturbance, psychological distress, or related outcomes in women with cancer. Data were charted and synthesized descriptively.

A total of 29 studies were included, predominantly randomized controlled trials. Interventions were categorized into five categories: exercise-based programs, mind-body and relaxation therapies, complementary therapies, psychosocial and behavioral interventions, and technology-based or nurse-led care models. Exercise-based interventions consistently reduced fatigue, likely through improvements in physical capacity. Mind-body approaches improved psychological distress and sleep quality by modulating stress responses. Psychosocial interventions enhanced coping and emotional regulation, while complementary therapies provided short-term relief of subjective symptoms, although with greater variability. Technology-based and nurse-led interventions improved accessibility, adherence, and self-management. While many interventions were associated with improvements in individual symptoms, multicomponent approaches demonstrated broader and more sustained benefits across fatigue, sleep, and psychological outcomes. However, only a limited number of studies explicitly incorporated a symptom-cluster framework.

Non-pharmacological interventions are associated with meaningful improvements in symptom burden among women with cancer. However, a critical gap persists between the multidimensional nature of symptom experience and the predominantly single-modality design of interventions. Future research should prioritize the development of integrated, multicomponent strategies explicitly targeting symptom clusters to enhance clinical effectiveness and patient-centered care.