A systematic review of the effectiveness of problem‐solving approaches towards symptom management in cancer care

Aims. To investigate the evidence of problem‐solving approach interventions on symptom management in cancer care. Background. Symptom‐related problems are a common challenge in cancer care. The problem‐solving approach is one strategy of cognitive behavioural therapy used to help patients with cancer self‐manage their symptoms. However, no systematic review has investigated the effectiveness of this approach. Design. Systematic review. Method. A systematic search for intervention studies using randomised controlled designs, controlled clinical trial and quasi‐experimental studies designs was conducted using the following electronic databases: EBSCO host, CINAHL (1991–2008), Medline (1975–2009), Electronic Periodical Services (Chinese) and Electronic Theses and Dissertations System (Taiwan). Results. Seven studies published in English between 1975–2009 were included in this systematic review. All studies were randomly assigned and almost all studies demonstrated the positive effects of a problem‐solving approach in reducing symptomatic problems in the target participants. Varying protocols and qualities of methodological design (14% good, 43% fair and 43% poor) were found in this review. Conclusions. This systematic review highlighted the potential of a problem‐solving approach in the management of symptom problems in patients with cancer. However, more rigourous studies are needed and a better evaluation of the most effective problem‐solving approach protocols is required. Relevance to clinical practice. Cancer care nurses should explore the use of problem‐solving approach interventions in their practice as the evidence base suggests the value of this approach – but caution is needed in regard to the precise structure of the problem‐solving approach protocol.