Objective To systematically describe and evaluate studies on self-help interventions for colorectal cancer ostomy patients using an evidence map approach.
Methods SinoMed, CNKI, Wanfang Data, VIP, PubMed, Web of Science, Cochrane Library, and Embase were searched from inception to July 2024 to retrieve randomized controlled trials (RCTs) and systematic reviews/Meta-analyses on self-help interventions for colorectal cancer patients with ostomies. The ROB 1.0 and AMSTAR 2 tool were used to assess the quality of included studies. Outcomes were classified according to the International Classification of Nursing Outcomes. Bubble charts were used to comprehensively present intervention types, intervention pathways and study conclusions of the outcome.
Results A total of 47 articles were included, with 42 RCTs and 5 systematic reviews/Meta-analyses. The RCTs were classified into three intervention types and 11 self-help intervention methods: 3 articles focused on completely self-managed interventions, 13 on purely self-help interventions, and 26 on guided self-help interventions. The intervention methods mainly involved online self-help tools such as WeChat, ostomy-specific management software, and multimedia. The primary outcome indicators included quality of life (24 articles), ostomy-related complications (19 articles), and self-care ability (16 articles). Most studies showed that self-help interventions were effective in colorectal cancer ostomy patients, with only 3 showing no significant effect. Systematic reviews/Meta-analyses all focused on guided self-help interventions. The intervention methods involved telephones, the Internet, with primary outcome indicators being self-management ability, quality of life, anxiety and depression. 3 studies showed that self-help interventions were effective in colorectal cancer ostomy patients, while 2 studies showed no significant effects.
Conclusion The results of the evidence map show that self-help interventions such as mobile phones and the internet can effectively improve the self-management ability of enterostomy patients and reduce the incidence of stoma complications. However, the effects vary across different intervention types and durations. High-quality research incorporating technologies such as big data is needed in the future to establish a precise and intelligent intervention system and to focus on long-lasting effects.
1.Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.
2.姚一菲, 孙可欣, 郑荣寿. 《2022全球癌症统计报告》分析解读: 中国与全球对比[J]. 中国普外基础与临床杂志, 2024, 31(7): 769-780. [Yao YF, Sun KX, Zheng RS. Interpretation and analysis of the global cancer statistics report 2022: a comparison between China and the world[J]. Chinese Journal of Bases and Clinics in General Surgery, 2024, 31(7): 769-780.] DOI: 10.7507/ 1007-9424.202406046.
3.Merritt C, Maldonado P. Management of the difficult stoma[J]. Surg Clin North Am, 2024, 104(3): 579-593. DOI: 10.1016/j.suc.2023. 11.008.
4.Liu Y, Wang L, Zhu L. The impact of stoma management education on the self-care abilities of individuals with an intestinal stoma[J]. Br J Nurs, 2023, 32(6): S28-S33. DOI: 10.12968/bjon.2023.32.6.S28.
5.Lin L, Fang Y, Wei Y, et al. The effects of a nurse-led discharge planning on the health outcomes of colorectal cancer patients with stomas: a randomized controlled trial[J]. Int J Nurs Stud, 2024, 155: 104769. DOI: 10.1016/j.ijnurstu.2024.104769.
6.Marinova P, Marinova R. Patient-centred stoma care support: ileostomy patients[J]. Br J Community Nurs, 2024, 29(8): 384-390. DOI: 10.12968/bjcn.2024.0065.
7.Shafran R, Egan SJ, de Valle M, et al. A guide for self-help guides: best practice implementation[J]. Cogn Behav Ther, 2024, 53(5): 561-575. DOI: 10.1080/16506073.2024.2369637.
8.唐莹, 王国燕, 徐永超, 等. 2型糖尿病患者自助干预的证据图谱[J]. 昆明医科大学学报, 2023, 44(11): 100-107. [Tang Y, Wang GY, Xu YC, et al. Evidence mapping for self-help interventions in patients with type 2 diabetes mellitus[J]. Journal of Kunming Medical University, 2023, 44(11): 100-107.] DOI: 10.12259/j.issn.2095-610X.S20231115.
9.刘小菲, 刘艳丽, 周丽君, 等. 引导自助干预在慢性病管理中的应用进展[J]. 护理学杂志, 2023, 38(16): 125-128. [Liu XF, Liu YL, Zhou LJ, et al. Application of guided self-help intervention in chronic disease management: a review[J]. Journal of Nursing Science, 2023, 38(16): 125-128.] DOI: 10.3870/j.issn.1001-4152.2023.16.125.
10.张珊珊, 孟昭磊. 引导自助干预在抑郁症患者中的应用研究进展[J]. 中国临床护理, 2024, 16(6): 377-382. [Zhang SS, Meng ZL. Research progress on the application of guided self-help intervention in patients with depression[J]. Chinese Clinical Nursing, 2024, 16(6): 377-382.] DOI: 10.39/j.issn.1674-3768. 2024.06.011.
11.Hao J, Xu Y, Li H. The value of applying a continuous nursing model based on virtual platforms for patients with colostomy or ileostomy[J]. Adv Skin Wound Care, 2023, 36(4): 206-212. DOI: 10.1097/01.ASW.0000919960.94295.53.
12.吴文俊, 张赤道, 孙阳, 等. 中成药治疗慢性肺源性心脏病临床研究证据图分析[J]. 中国中药杂志, 2024, 49(19): 5354-5364. [Wu WJ, Zhang CD, Sun Y, et al. Analysis of evidence map of clinical research on Chinese patent medicines in treatment of chronic pulmonary heart disease[J]. China Journal of Chinese Materia Medica, 2024, 49(19): 5354-5364.] DOI: 10.19540/j.cnki.cjcmm.20240611.501.
13.中华医学会肿瘤学分会, 国家卫生健康委员会医政司. 中国结直肠癌诊疗规范(2023版)[J]. 协和医学杂志, 2023, 14(4): 706-733. [Chinese Medical Association Oncology Branch, Medical Administration Department of National Health Commission. Chinese guidelines for the diagnosis and treatment of colorectal cancer (2023 edition)[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 706-733.] DOI: 10.12290/xhyxzz.2023.0315.
14.Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials[J]. BMJ, 2011, 343: d5928. DOI: 10.1136/bmj.d5928.
15.Hoffmann-Eßer W, Siering U, Neugebauer EA, et al. Guideline appraisal with AGREE II: systematic review of the current evidence on how users handle the 2 overall assessments[J]. PLoS One, 2017, 12(3): e174831. DOI: 10.1371/journal.pone.0174831.
16.黄蓉, 袁倩, 易继群, 等. 护理结局分类系统在临床护理实践中的应用研究进展[J]. 护理研究, 2022, 36(20): 3655-3659. [Huang R, Yuan Q, Yi JQ, et al. Research progress on the application of the nursing outcomes classification system in clinical nursing practice[J]. Chinese Nursing Research, 2022, 36(20): 3655-3659.] DOI: 10.12102/j.issn.1009-6493.2022.20.016.
17.Mo J, Wendel CS, Sloan JA, et al. Stoma location and ostomy-related quality of life among cancer survivors with ostomies: a pooled analysis[J]. Am J Surg, 2022, 223(5): 963-968. DOI: 10.1016/j.amjsurg.2021.09.023.
18.van Beers E, Melisse B, de Jonge M, et al. Web-based guided self-help cognitive behavioral therapy-enhanced versus treatment as usual for binge-eating disorder: a randomized controlled trial protocol[J]. Front Psychiatry, 2024, 15: 1332360. DOI: 10.3389/fpsyt.2024.1332360.
19.Headley E, Kellett S, Bee C, et al. Types and mechanisms of idiographic change during guided self-help for anxiety[J]. Psychol Psychother, 2024, 97(3): 498-517. DOI: 10.1111/papt.12536.
20.Gao XT, Huang KC, Cui X, et al. WeChat-assisted health education improves care ability, reduces care burden and improves quality of life of parents of infants after enterostomy[J]. J Paediatr Child Health, 2021, 57(7): 1067-1071. DOI: 10.1111/jpc.15399.
21.Zhang WY, Zhuang HR, Yu HP, et al. The effect of telemedicine on stoma-related complications in adults with enterostomy: a systematic review and Meta-analysis[J]. Int Wound J, 2024, 21(1): e14572. DOI: 10.1111/iwj.14572.
22.Azer SA, AlKhawajah NM, Alshamlan YA. Critical evaluation of YouTube videos on colostomy and ileostomy: can these videos be used as learning resources?[J]. Patient Educ Couns, 2022, 105(2): 383-389. DOI: 10.1016/j.pec.2021.05.023.
23.王颖, 郭玉芳, 李扬, 等. 引导自助干预在焦虑症治疗中的应用特征的范围综述[J]. 护理研究, 2022, 36(8): 1420-1424. [Wang Y, Guo YF, Li Y, et al. Application characteristics of guided self-help intervention in the treatment of anxiety disorders:a scoping review[J]. Chinese Nursing Research, 2022, 36(8): 1420-1424.] DOI: 10.12102/j.issn.1009-6493.2022.08.019.
24.Yan Q, Li Y. Micro video incentive nursing intervention improves the psychological state and quality of life in patients with rectal cancer after enterostomy[J]. Am J Transl Res, 2023, 15(3): 2040-2048. https://pubmed.ncbi.nlm.nih.gov/37056851/
25.Lin L, Fang Y, Huang F, et al. Discharge teaching quality positively predicts quality of life in colorectal cancer patients with temporary enterostomy: the mediating role of readiness for hospital discharge and stoma self-efficacy[J]. PLoS One, 2024, 19(7): e306981. DOI: 10.1371/journal.pone.0306981.