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A meta-analysis of intervention effectiveness for symptom management in oncology nursing research
M C Smith1, J K Holcombe, E Stullenbarger
1University of Alabama at Birmingham.
Purpose:
To describe intervention effectiveness for symptom management in oncology nursing research.
Design:
Integrative research review and meta-analysis.
Sample:
28 randomized experimental and control group studies of symptom management that were identified from 428 published and unpublished oncology nursing research reports authored by nurses from 1981-1990.
Methods:
Experimental studies identified and coded by four oncology nurse specialists; findings transformed into effect sizes; effect sizes combined into overall effect for 28 studies; and effects clustered by symptoms, interventions, and outcomes.
Main Outcome Measure:
Combined effect for 28 symptom management study outcomes.
Findings:
For 28 study outcomes tested for symptom management, weighted average effect was d = 0.47, the 95% confidence interval ranged from 0.31 to 0.61, statistical significance was p = 5.17 x 10(-12) with wide variability of effect (chi 2 = 66.574, df = 27, p = 3.41 x 10(-5), and success rate improved from 39% to 62% for subjects in the treatment group.
Conclusion:
Interventions were effective in relieving symptoms in the collection of studies and in the clusters for managing nausea and vomiting, pain, anxiety, alopecia, infection, and side effects of chemotherapy.
Implications For Nursing Practice:
Missing data related to subject characteristics and need for replications prior to use in practice preclude making specific recommendations at this time for research-based nursing interventions for symptom management in patients with cancer.