Effect of nurse-led and physician-led multidisciplinary team palliative care on quality of life, negative emotions, and pain for cancer patients: A meta-analysis

Abstract

To systematically evaluate the effect of nurse-led and physician-led multidisciplinary team (MDT) palliative care models on quality of life, negative emotions, and pain for cancer patients. A comprehensive literature search of randomized controlled trials (RCTs) published in nine databases was conducted. Data analysis was performed using RevMan5.3. The findings were summarized using a random effects model of mean differences with 95% confidence intervals. The search strategy identified 15 articles involving 1850 cancer patients. MDT hospice care improved quality of life among cancer patients (SMD = 1.77, 95% CI [1.08, 2.46], Z = 5.02, p < .001), with nurse-led care (SMD = 3.04, 95% CI [2.29, 3.79], Z = 7.95, p < .001) providing better effects than physician-led care (SMD = 0.5, 95% CI [0.33, 0.67], Z = 5.76, p < .001). Furthermore, MDT hospice care significantly alleviated depression (SMD = –1.31, 95% CI [−1.49, −1.12], Z = 14.18, p < .001) and anxiety (SMD = –1.11, 95%CI [−1.29, −0.92], Z = 11.69, p < .001) and reduced patients' pain (SMD = –0.92, 95% CI [−1.13, −0.7], Z = 8.37, p < .001). Nurse-led care provided better effects for relieving anxiety and depression, while physician-led care provided better effects for relieving pain. The findings of the meta-analysis indicate that MDT palliative care can improve the quality of life for cancer patients and alleviate their depression, anxiety and their pain. Nurse-led care was superior in terms of quality of life, depression, and anxiety indicators, while physician-led care had a more significant effect on pain relief.

Keywords

cancer / meta analysis / multi-disciplinary collaboration / nurse-led care / palliative care / physician-led care

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RIGHTS & PERMISSIONS

2024 The Author(s). Precision Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Cancer Hospital.