The objective of this review is to synthesize the best available evidence on the effectiveness of individualised survivor care plans as compared to usual care on quality of life for adult female breast cancer survivors.

Review Question

In the adult female breast cancer survivor what is the effect of an individualised survivorship care plan as compared to usual care on quality of life?

The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of MEDLINE and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published in English will be considered for inclusion in this review. Studies published from 1980 when this intervention was first introduced to present will be considered for inclusion in this review.

The databases to be searched include: CINAHL, PubMed, Embase, PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL), Academic Search Premier, Health Source: Nursing/Academic Edition, ProQuest, Sage, Salem Health.

The search for find published and unpublished studies. 1). The CINAHL, MEDLINE, Embase, Academic Search Premier, PsycINFO, Cochrane Clinical Trials and the National Library of Medicine databases will be searched for randomized control studies. 2). Grey literature sites to be explored are: Dissertation Abstracts online, Google scholar, government health department websites, Institute of Medicine, UpToDate.com, the Virginia Henderson Library of Sigma Theta Tau International and any relevant oncology web sites. 3). A hand search of appropriate journals (e.g. American Journal of Clinical Oncology, Annals of Oncology, Journal of Clinical Oncology, Clinical Journal of Oncology Nursing , Cancer Nursing, The Journal of National Comprehensive Cancer Network, Seminars in Oncology Nursing, and The Oncologist) for the preceding year will be conducted to ensure all relevant studies have been considered.

The initial keywords to be used will be: adult, female, breast cancer, survivorship care plans, quality of life, breast malignancy, breast carcinoma, breast tumor, carcinoma insitu, woman, survivorship program, care pathways, forward planning, forward care, post treatment care, surviving after cancer, survivorship surveillance, continuum of care, individual care plan, transitional care, post treatment care, follow up medical care, comprehensive care plan, and patient centered care plan.

This review will consider both experimental and epidemiological study designs including randomised controlled trials, non-randomised controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case control studies and analytical cross sectional studies as appropriate for inclusion.

Breast cancer is cancer (malignant cells) that develops in the breast tissue. It is most commonly seen in the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). This type of cancer is most common in women worldwide, comprising 16% of all female cancers.Breast cancer survivors make up the largest group of cancer survivors (22%) and according to the US National Institute of Health (NIH), there are more than 2.5 million breast cancer survivors in the United States.

This review will consider studies that include adult female breast cancer survivors, 18 years of age or older. A breast cancer survivor will be defined as one who has completed treatment for breast cancer and are considered cured, but who continue to experience the emotional and physical impact of the disease. The concept of survivorship and quality of life will cover the physical, psychosocial, and sexual issues of cancer.

This review will consider individualised survivorship care plans as the additional intervention provided to adult female with breast cancer survivors receiving the standard or routine care.

The comparator: usual care. Usual care is standard or routine care for adult female breast cancer survivors.

None.

Primary outcomes

This review will consider studies that include the following outcome measures: survivor’s quality of life as it relates to physical, psychosocial, and sexual health. These outcome measures are critical components of survivorship care plans. Studies will be reviewed for evidence of standardised valid and reliable tools measuring quality of life in breast cancer survivors, such as the Long Term Quality of Life Breast Cancer (LTQOL-BC) scale and the Cancer Rehabilitation Evaluation System-Short Form (CARES-SF). The LTQOL-BC measures seven domains which include physical, sexual and cognitive function, body image, coping, social support, and anxiety. The CARES-SF instrument assesses the rehabilitative and quality of life needs of cancer patients. The tool is a questionnaire with five sub-scales measuring quality of life domains that include physical, psychosocial, medical interaction, marital, and sexual. Other tools identified in the studies will be appraised for their reliability and validity.

Secondary outcomes

None

Data will be extracted from papers included in the review using the standardised data extraction tool from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument JBI-MAStARI The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.

This review aims to synthesise the best available evidence. The purpose is to include the highest quality of evidence possible. The methodological quality of eligible studies will be assessed independently by two reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklists for experimental studies, cohort/case control studies and descriptive/case series studies (Appendix I). Papers selected for retrieval will be assessed by two independent reviewers for methodological quality prior to inclusion in the review using standardised critical appraisal instruments to assess the methodological quality of studies that aim to identify sources of bias with JBI-MAStARI. The randomised controlled and pseudo-randomised controlled trials chosen will meet a minimum of six out of 10 questions from the standardised critical appraisal instrument from JBI-MAStARI, with questions 1, 6, 7, 8, 9 and 10 being the most significant, to be considered of adequate quality for inclusion in the review. Chosen cohort/case control studies and descriptive/case studies will meet a minimum of five out of nine questions from the standardised critical appraisal instrument from JBI-MAStARI. Questions 1, 5, 7, 8, and 9 must be significant for cohort/case control studies and questions 1, 4, 7, 8, and 9 must be significant for descriptive/case series studies to be considered adequate quality for inclusion in the review. Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Quantitative data will, where possible, be pooled in statistical meta-analysis, using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis as appropriate. Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate.

Heterogeneity will be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the different study designs included in this review.

If appropriate , the findings from this systematic review will inform Joanna Briggs Institute Best Practice Information Sheets , Evidence Summaries and Consumer Information Sheets.

Joanna Briggs Institute Synthesis Science Unit (JBI SSU)

Synthesis Science Unit (SSU)

The Joanna Briggs Institute

Faculty of Health Sciences

The University of Adelaide

SA 5005

AUSTRALIA

jbiresearch@adelaide.edu.au

Pace University, College of Health Professions, Lienhard School of Nursing and New Jersey Center for Evidence Based Practice at UMDNJ School of Nursing; A Collaborating Centre of the Joanna Briggs Institute

http://umdnj.edu

Ms Teri A. Martin, Pace University, New York, NY
Ms Rose M. Moran-Kelly, Pace University, New York, NY
Ms Joanna G. Powe, Pace University, New York, NY
Ms Lucy M. Roberts, Pace University, New York, NY
Ms Sandra N. Farrell, Pace University, New York, NY
Ms Catherine M. Concert, Pace University, New York, NY
Dr Joanne Singleton, Pace University, College of Health Professions, Lienhard School of Nursing and New Jersey Center for Evidence Based Practice at UMDNJ School of Nursing; A Collaborating Centre of the Joanna Briggs Institute

20 August 2012

20 February 2014

Pace University, College of Health Professions, Lienhard School of Nursing and New Jersey Center for Evidence Based Practice at UMDNJ School of Nursing; A Collaborating Centre of the Joanna Briggs Institute.

None known

The Joanna Briggs Institute PRO 698

English

United States of America

Subject indexing assigned by CRD

Breast Neoplasms; Humans; Patient Care Planning; "Quality of Life"; Survivors

21 September 2012

21 September 2012