Conectar
To synthesise qualitative evidence on how patients, caregivers and healthcare professionals perceive and respond to cancer-related anorexia (CRA), and to develop a multi-level framework for improving CRA care.
A qualitative meta-synthesis using the Joanna Briggs Institute (JBI) methodology, informed by the Social Ecological Model (SEM).
Seven databases were searched for qualitative studies from inception to April 2025. Studies were assessed using the JBI Critical Appraisal Checklist. Meta-aggregation was used to synthesise findings, and the ConQual method assessed confidence levels.
PubMed, Embase, CINAHL, PsycINFO, Cochrane Library, CNKI and WanFang.
Seventeen studies from 10 countries were included, reflecting the perspectives of patients, caregivers and healthcare professionals. Four synthesised findings were identified. At the individual level, CRA was linked to physical decline, emotional distress and changes in identity. The interpersonal level involved feeding-related tensions and caregiver burden. Organisational barriers included delayed care and poor cultural responsiveness. Policy-level factors such as limited insurance coverage and rural access further impeded care. Overall confidence in these synthesised findings was low to moderate.
CRA is not solely a biological condition but a multidimensional experience. Addressing CRA requires integrated and context-sensitive strategies across personal, relational, organisational and policy domains.
Nurses and clinicians should address not only physical symptoms but also the emotional and social dimensions of eating. Structured support for caregivers and improved service access, particularly in underserved settings, are needed.
This study provides a multi-level understanding of CRA. The findings support better patient care, caregiver support and more equitable healthcare policy design.
JBI methodology and ENTREQ guideline.
No Patient or Public Contribution.
PROSPERO Database: CRD420251041265
Radiotherapy (RT) can cause a range of negative impacts in addition to the intended treatment impacts. Pulmonary rehabilitation (PR) may improve the physical and psychological conditions of patients with lung cancer receiving RT, but specific evidence is lacking. This review mapped the evidence on PR in patients with lung cancer receiving RT for intervention characteristics and outcome assessments.
PubMed, EMBASE, CINAHL, Proquest, Web of Science, CNKI and WanFang were searched for studies from January 2003 to April 2025.
We included randomised controlled trials and non-randomised comparative intervention studies that included centre-based PR in patients ≥18 years with lung cancer who were receiving RT. PR was defined as any type of exercise, respiratory training, or both and/or at least one additional component (eg, psychological support). Studies were excluded if they were not available in English, were not full-text articles or were non-peer-reviewed.
Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data. PR components and the typology of outcome assessments used were mapped at the final data synthesis level.
Out of 3120 records, nine studies were investigated in the final data synthesis. In these studies, in addition to exercise or respiratory training, psychological support and disease education were the most common components of PR. Pulmonary function, quality of life, symptom assessment and exercise performance were commonly assessed outcomes in these included studies. Although the effectiveness of PR is difficult to synthesise, the evidence for improvements in exercise performance and symptoms of dyspnoea and anxiety/depression is promising.
Evidence on PR in patients with lung cancer receiving RT is sparse, and there is a heterogeneous understanding of PR. The development of standardised PR protocols and investigation of the capabilities of PR in this growing and under-represented patient population are essential.
FreshRSS 