Introduction and Search History

The purpose of this project is to evaluate the effectiveness of a nurse-driven exercise program compared to staying inactive to reduce cancer-related fatigue (CRF) among cancer patients. Cancer-related fatigue remains a significant healthcare problem among cancer patients undergoing treatments such as chemotherapy. The effects of CRF limit cancer patients undergoing treatment to engage in their normal daily activities because they lack energy (Zhang, Li, Zhang, Yu, & Cong, 2018). Specifically, the proposed study endeavors to determine the effectiveness of a nurse-driven exercise program aimed at reducing CRF as compared to when cancer survivors stay inactive. The goal is to assist patients in improving their fatigue levels during their hospital stay and after discharge. Therefore, finding and reviewing the current literature on reducing CRF is important for healthcare providers. This paper will include a search strategy to locate current evidence related to the PICOT question as well as appraise the evidence synthesis the articles reviewed and offer recommendations for practice change. 

Search history

The researcher will perform a comprehensive literature search to locate background evidence and gaps that need to be filled in the literature. The researcher will utilize various databases to search for evidence-based research that addresses the PICOT question. The databases incorporate Google Scholar, Medline through PubMed CINAHL Plus with Full Text, EBSCOhost, and the Cochrane Library. EBSCOhost databases enable users to search several databases simultaneously using keywords (Gusenbauer & Haddaway, 2020). Keywords used for searching the databases include cancer-related fatigue, physical activity, chemotherapy, exercise, cancer survivors, and nurse-driven exercise program. The authors will delimit the search by clicking on "Find all my search terms" and "Also search with a full test of the articles." Full-Text articles will be specified and ensuring that only peer-review articles are included. In the search, the researcher will also specify articles that were published between 2015 and 2020.  All the studies that will be reviewed are those published within the last five years.

Integration of Evidence 

Evidence relating to the PICOT question will be integrated to determine the extent of the problem. Ten evidence-based studies relating to the PICOT question will be reviewed systematically to build on the knowledge gap. The articles included in the review are those published within the last five years.

Cancer and Cancer-Related Fatigue

This section will describe the prevalence and incidence of cancer and cancer-related fatigue. The definition of CRF and its cause will also be discussed in this section. The researcher will also dig deep into the features and consequences of CRF and justify why the issue needs to be dealt with in the oncology department.

Immobility and Effects on CRF  

This section will address the part of the PICO question that concerns the effect of inactivity on cancer-related fatigue. The issues related to inactivity are important when viewed from the perspective of oncology patients who have additional comorbidities. Some studied suggest that physicians recommend that oncology patients need to rest after chemotherapy and avoid physical activity for comfort reasons. This section will also demonstrate how the inactivity can lead to other comorbidities and CRF.

Effects of Exercise on CRF

This section will review the benefits of exercise and how it impacts CRF. The discussion will incorporate the effects of exercise on a person’s psychological well-being by considering the effects of exercise on stress, anxiety, and depression. Psychological well-being is vital for the prevention and management of cancer-related fatigue. In this section, evidence will be drawn to support the evidence-based conclusion that the use of exercise is an efficient intervention to decrease cancer-related fatigue.

Critique of Evidence

A critique of the evidence presented will be done in this section. The researcher will employ a critical appraisal guide for nurses and nursing students that rates empirical evidence according to an eight-level hierarchy (Ingham-Broomfield, 2016). Each article will be appraised based on the eight-level hierarchy. The researcher will determine whether the search terms were used appropriately to search for the articles integrated into the review. From the critique, one can determine whether the evidence used ill make the study reliable.

Gaps in Evidence

From the integrated evidence and critique, the researchers will identify the literature gap that needs to be filled by the study. The gaps in the evidence presented will be used to guide the study to find the effective intervention to reduce CRF.

Implication for Practice 

The applicability of the evidence presented in a clinical setting will be evaluated. The implications for patients to reduce fatigue will also be assessed to determine the most effective intervention. The recommendations for practice will also be addressed in this section.

Conclusion

This section will summarize the evidence-based studies reviewed and their implications for practice. The researcher will summarize the major themes, critique, and the knowledge gaps identified in the literature that need to be filled by the current study.

References

Gusenbauer, M., & Haddaway, N. R. (2020). Which academic search systems are suitable for systematic reviews or metaanalyses? Evaluating retrieval qualities of Google Scholar, PubMed, and 26 other resources. Research synthesis methods11(2), 181-217.

Ingham-Broomfield, J. R. (2016). A nurses' guide to the hierarchy of research designs and evidence. Australian Journal of Advanced Nursing (Online)33(3), 38.

Zhang, Q., Li, F., Zhang, H., Yu, X., & Cong, Y. (2018). Effects of nurse-led home-based exercise & cognitive behavioral therapy on reducing cancer-related fatigue in patients with ovarian cancer during and after chemotherapy: A randomized controlled trial. International Journal of Nursing Studies78, 52-60.

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