[What does really help against cancer-related fatigue? An overview of systematic reviews].

Cancer-related fatigue, a subjective feeling of a distinctive physical, emotional and/or cognitive tiredness, is a common phenomenon in patients with cytotoxic chemotherapy or radiotherapy. Research on cancer-related fatigue has been intensified in the last decade. The objective of this work was to give an overview of the effectiveness of non-pharmacological interventions for cancer-related fatigue. Therefore, the databases of the Cochrane Library, PubMed, CINAHL and DAHTA were searched for systematic reviews. Two persons independently selected the reviews and assessed the methodological quality. We used the measurement tool AMSTAR to assess the methodological quality of each systematic review. The results were summarised in a qualitative synthesis. A total of 24 reviews were included in the analysis. The results show that physical activity and psycho-social support can reduce fatigue in cancer patients. Particularly, nurse-led fatigue specific interventions proved to be effective. Currently the evidence for other intervention types is weak; however there exist some promising approaches. Despite a large number of randomised clinical trials as well as systematic reviews the evidence base is still deficient in many respects. The results can be used by nurses in clinical care, counselling and education of cancer patients.