Experiences of adult cancer patients receiving counseling from nurses: a qualitative systematic review.

INTRODUCTION: Counseling is a brief psycho-educational intervention that is useful in facilitating personal growth and adaptive resolution of life stresses. With increased recognition on the psycho-emotional needs of patients with cancer, it is prudent to consider the possibility of expanding the role of nurses in the provision of counseling. OBJECTIVE: This qualitative systematic review aimed to establish the best available evidence on the experiences of adult cancer patients receiving counseling provided by nurses. INCLUSION CRITERIA: This review included studies on adult cancer patients of at least 18 years of age who were diagnosed with oncological malignancies of any type and staging. The phenomena of interest were the experiences of adult cancer patients who received nurse counseling (patient education, psycho-education and/or supportive counseling) that was conducted face-to-face or via other communication modes. The review included studies done in institutional and community settings. Qualitative data including, but not limited to, designs of phenomenology, grounded theory, ethnography, action research, feminist research and mixed methods research were considered. SEARCH STRATEGY: A three-step search strategy was utilized to find both published and unpublished studies in the English language. Databases searched included CINAHL, MEDLINE, Embase, JSTOR, PsycINFO, Scopus, ScienceDirect, Wiley Online Library and ProQuest Dissertations and Theses Global. Two reviewers independently appraised the 14 included studies using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. The studies were of moderate to high quality, mostly, falling short in quality due to lack of statements locating the researchers and their influence on the research. Data were extracted from included papers using the standardized JBI data extraction tool. DATA SYNTHESIS: Two reviewers independently reviewed and pooled similar findings into categories. All three reviewers then collaborated in finalizing these derived categories to generate a meta-synthesis. RESULTS: Five synthesized findings were generated during the meta-synthesis: (1) Nurses provide tailored information and teaching to enhance patients' coping; (2) Nurses attend to patients' emotional needs; (3) Nurses assume the role of a significant person in the patients' journey; (4) Patients feel valued as a whole person and the ready availability of nursing interactions; and (5) Nursing role ambiguity and time constraints limit nurse counseling. CONCLUSION: Overall, cancer patients' experiences with nurse counseling are positive and beneficial to them. Despite some nursing role ambiguity and time constraints impeding nurse counseling, this review has established the diverse instrumental roles nurses have played in enhancing adaptive coping in patients across their illness trajectory. In particular, the nurses' presence and availability, a trusting nurse-patient relationship, use of psychotherapy techniques, a holistic approach, human touch and continuity of care were highlighted as key factors in enhancing healing. The role of the nurse navigator and the use of expressive writing warrant more attention when tending to patients' psycho-emotional distress.

Effectiveness of polyhexamethylene biguanide impregnated dressing in wound healing: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to review and synthesize evidence on the effectiveness of polyhexamethylene biguanide (PHMB) impregnated dressing in wound treatment for patients with chronic or acute wounds, compared with standard dressings or any other antimicrobial dressings.Specifically the questions for this review are.

Experiences of adult cancer patients receiving counseling from nurses: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The aim of this review is to establish the best available evidence on the experiences of adult patients with cancer receiving counseling provided by nurses in the institutional and community setting.

Effectiveness of nurse leader rounding and post-discharge telephone calls in patient satisfaction: a systematic review.

BACKGROUND: Patients' satisfaction with hospital services is an important indicator in demonstrating that nursing care meets their expectations. Hospitals are responsible for providing safe and quality care to patients during their hospitalization and ensuring patients receive continued care post­discharge. Interventions such as nurse leader rounding and post-discharge telephone calls could potentially enhance patients' hospital stay, meeting their expectations and needs in a timely manner. OBJECTIVES: The objective of this review was to synthesize the best available evidence on the effectiveness of nurse leader rounding and post-discharge telephone calls in patient satisfaction of nursing and hospital services. TYPES OF PARTICIPANTS: The review included studies of adult patients (aged 18 years or older) who had been admitted to hospital. Studies undertaken in outpatient settings were excluded. TYPES OF INTERVENTION(s): The interventions studied were nurse leader rounding and post-discharge telephone calls. There was no comparator. TYPES OF STUDIES: This review considered studies with experimental designs, including randomized controlled trials, non-randomized controlled trials, quasi-experimental designs, and before and after studies. It also considered studies with analytical and descriptive epidemiological designs, including prospective and retrospective cohort studies, case control studies, analytical cross­sectional studies, case series, and individual case reports. TYPES OF OUTCOMES: The primary outcome was patients' satisfaction with nursing and hospital services. SEARCH STRATEGY: A search for published and unpublished English language studies from 2003 to 2013 was conducted in seven major electronic databases. They were Cochrane Central Register of Controlled Trials, Scopus, Web of Science, MEDLINE, CINAHL, Embase, PsycINFO and Mednar. A three-step search strategy was used, developing MeSH terminology and keywords to search and retrieve all relevant literature for the review. METHODOLOGICAL QUALITY: Two reviewers appraised the methodological quality of the studies independently, using the Joanna Briggs Institute's standardized critical appraisal instruments. DATA EXTRACTION: Data was extracted from the studies using the standardized data extraction tool. The authors of primary studies were contacted for missing information or data. DATA SYNTHESIS: Statistical pooling was not possible due to the included studies being descriptive study design. Therefore, the data was presented in narrative summary. RESULTS: Three studies were included in the review. The evidence was weak to suggest that nurse leader rounding and post-discharge telephone calls were effective in enhancing patients' satisfaction. CONCLUSIONS: The interventions on nurse leader rounding and post-discharge telephone calls had increased patients' satisfaction of nursing and hospital services.

Prediction of adverse events in patients receiving rapid rituximab infusion: validation of a predictive model.

Rapid rituximab infusion was approved as treatment for non-Hodgkin lymphoma by the U.S. Food and Drug Administration in 2012, but it has been administered clinically since approval of the drug rituximab in 1997. Because of the delay between the approval of the drug and the approval of the procedure, researchers sought to discover predictors for adverse events related to rapid rituximab infusion. The current study is a retrospective cohort study using medical records from a cancer center in Singapore. The purpose of the study is to validate whether high absolute lymphocyte counts can predict the occurrence of adverse events from rapid rituximab infusion over 90-minute intervals. A total of 120 patients were selected by purposive sampling, and 394 cycles of rapid rituximab infusions were available for analysis. The authors found that high absolute lymphocyte count is highly specific in identifying patients who will not experience any adverse event from rapid rituximab infusion. However, lack of sensitivity can occur when screening potential patients for adverse events.

Predictors of acute adverse events from rapid rituximab infusion.

PURPOSE: This study aimed to identify the predictors of acute adverse events resulting from rapid rituximab infusion over 90 min. METHOD: It was a retrospective cohort study using medical record review based on a convenience sampling from 2007 till May 2011 in both in-patient and ambulatory setting in Royal Adelaide Hospital. RESULTS: There were a total of 294 patients who received 376 courses and 1,571 cycles of rapid rituximab infusion. Forty-three (14.6 %) patients experienced acute adverse events of hypotension being the most commonly occurring events followed by patients feeling hot and face-flushed. There were 11 predictors analysed, namely age, gender, diagnosis, stage of disease, presence of cardiac or lung morbidities, type of treatment, number of course and cycles, total white blood cells count, lymphocyte counts and lactate dehydrogenase using log generalised estimating equation for univariate and multivariate analysis. The findings successfully demonstrated that high lymphocyte counts were the independent predictor of acute adverse event from rapid rituximab infusion (p = 0.0009). Patient with high lymphocyte counts were 6.9382 times the odd to experience an adverse event as compared to those with normal lymphocyte counts. CONCLUSION: There are no specific patient characteristics to preclude prescribing rapid rituximab infusion following a 90-min regimen for non-Hodgkin lymphoma except a potential for adverse events to occur when patients have abnormally high lymphocyte counts.

Measurement accuracy of non-invasively obtained central blood pressure by applanation tonometry: a systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined. METHODS: We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP. RESULTS: Sufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference -1.1 ± 4.1mm Hg (95% limits of agreement -9.1-6.9 mm Hg) for central systolic BP; -0.5 ± 2.1mm Hg (-4.6-3.6mm Hg) for central diastolic BP; and -0.8 ± 5.1mm Hg (-10.8-9.2mm Hg) for central pulse pressure. However, the errors inflated to -8.2 ± 10.3mm Hg (-28.4-12.0mm Hg) for central systolic BP, 7.6 ± 8.7 mm Hg (-9.5-24.6mm Hg) for central diastolic BP, and -12.2 ± 10.4mm Hg (-32.5-8.1mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors. CONCLUSION: Present tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms.

Evaluation of the safety and feasibility of rapid rituximab infusion.

AIM: To assess safety of rapid infusion by measuring infusion-related side effects and toxicities. METHODS: Participants received the first rituximab infusion according to the manufacturers' recommendations. If well-tolerated, they then received the second and subsequent infusions at a rate of 20% of the dose over the first 30 min and the remaining 80% over the next hour. Premedication was administered for all the infusions. RESULTS: A total of 243 infusions in 65 consecutive participants were evaluated. Six experienced a grade 1 reaction and one a grade 3 transfusion-related adverse event. Three of these participants were withdrawn from the rapid infusion study. The other four participants (grade 1 only participants) were re-challenged. The same premedication was used as in the first rapid infusion. On experiencing a grade 1 reaction, promethazine 12.5 mg i.v. was administered and infusion recommenced at 50% of the previous rate upon the resolution of symptoms. Three patients developed a grade 1 adverse event and one patient experienced no adverse reaction. The three patients who did not tolerate the second rapid infusion were withdrawn from this study. CONCLUSION: A rituximab infusion over 90-min was safe and feasible for participants who seek treatment at ambulatory cancer centre. The new regimen has been adopted as a standard practice with better resource utilization.

Prognostic factors for risk stratification of adult cancer patients with chemotherapy-induced febrile neutropenia: a systematic review and meta-analysis.

BACKGROUND: Increasing numbers of studies identify new prognostic factors for categorising chemotherapy-induced febrile neutropenia adult cancer patients into high- or low-risk groups for adverse outcomes. These groupings are used to tailor therapy according to level of risk. However many emerging factors with prognostic significance remain controversial, being based on single studies only. OBJECTIVES: A systematic review was conducted to determine the strength of association of all identified factors associated with the outcomes of chemotherapy-induced febrile neutropenia patients. INCLUSION CRITERIA: The participants included were adults of 15 years old and above, with a cancer diagnosis and who underwent cancer treatment.The review focused on clinical factors and their association with the outcomes of cancer patients with chemotherapy-induced febrile neutropenia at presentation of fever.All quantitative studies published in English which investigated clinical factors for risk stratification of adult cancer patients with chemotherapy-induced febrile neutropenia were considered.The primary outcome of interest was to identify the clinical factors for risk stratification of adult cancer patients with chemotherapy-induced febrile neutropenia. SEARCH STRATEGY: Electronic databases searched from their respective inception date up to December 2011 include MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Science-Direct, Scopus and Mednar. METHODOLOGICAL QUALITY: The quality of the included studies was subjected to assessment by two independent reviewers. The standardised critical appraisal tool from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to assess the following criteria: representativeness of study population; clearly defined prognostic factors and outcomes; whether potential confounders were addressed and appropriate statistical analysis was undertaken for the study design. DATA COLLECTION: Data extraction was performed using a modified version of the standardised extraction tool from the JBI-MAStARI. Prognostic factors and the accompanying odds ratio reported for the significance of these factors that were identified by multivariate regression, were extracted from each included study. DATA SYNTHESIS: Studies results were pooled in statistical meta-analysis using Review Manager 5.1. Where statistical pooling was not possible, the findings were presented in narrative form. RESULTS: Seven studies (four prospective cohort and three retrospective cohort) investigating 22 factors in total were included. Fixed effects meta-analysis showed: hypotension [OR=1.66, 95%CI, 1.14-2.41, p=0.008] and thrombocytopenia [OR=3.92, 95%CI, 2.19-7.01, p<0.00001)] were associated with high-risk of adverse outcomes for febrile neutropenia. Other factors that were statistically significant from single studies included: age of patients, clinical presentation at fever onset, presence or absence of co-morbidities, infections, duration and severity of neutropenia state. Five prognostic factors failed to demonstrate an association between the variables and the outcomes measured and they include: presence of pneumonia, total febrile days, median days to fever, recovery from neutropenia and presence of moderate clinical symptoms in association with Gram-negative bacteraemia. CONCLUSIONS: Despite the overall limitations identified in the included studies, this review has provided a synthesis of the best available evidence for the prognostic factors used in risk stratification of febrile neutropenia patients. However, the dynamic aspects of prognostic model development, validation and utilisation have not been addressed adequately thus far. Given the findings of this review, it is timely to address these issues and improve the utilisation of prognostic models in the management of febrile neutropenia patients. IMPLICATIONS FOR PRACTICE: The identified factors are similar to the factors in current prognostic models. However, additional factors that were reported to be statistically significant in this review (thrombocytopenia, presence of central venous catheter, and duration and severity of neutropenia) have not previously been included in prognostic models. This review has found these factors may improve the performance of current models by adding or replacing some of the factors. IMPLICATIONS FOR RESEARCH: The role of risk stratification of chemotherapy-induced febrile neutropenia patients continues to evolve as the practice of risk-based therapy has been demonstrated to be beneficial to patients, clinicians and health care organisations. Further research to identify new factors /markers is needed to develop a new model which is reliable and accurate for these patients, regardless of cancer types. A robust and well-validated prognostic model is the key to enhance patient safety in the risk-based management of cancer patients with chemotherapy-induced febrile neutropenia.

Effectiveness of the Sitz bath in managing adult patients with anorectal disorders.

OBJECTIVE: The objective of this review was to critically analyze and systematically review the best evidence related to the effectiveness of the Sitz bath in managing adult patients with anorectal disorders. METHODS: The text terms were established and searched systematically from the relevant databases from 1990 to November 2009 in the English language. The eligible studies that were congruent with the review's inclusion criteria were selected. The selected studies were critically appraised for their methodological validity by two independent reviews and the data were extracted from the studies by using the Joanna Briggs Institute Systems Meta Analysis of Statistical Assessment and Review Instrument. The results were presented in narrative form because statistical pooling was not possible due to clinical heterogeneity. RESULTS: A total of four randomized controlled trials was included in the review. The use of the Sitz bath had no significant impact on reducing the overall intensity of pain and postoperative pain. Conflicting findings for postdefecation pain were reported. The Sitz bath had no impact on accelerating fissure or wound healing. However, the patients were satisfied with using the Sitz bath and no severe complication was reported. CONCLUSION: There was no strong evidence to support the use of the Sitz bath for pain relief and to accelerate fissure or wound healing among adult patients with anorectal disorders. However, the Sitz bath may be prescribed for patients' satisfaction.

Safety of rapid rituximab infusion in adult cancer patients: a systematic review.

The purpose of this study is to critically appraise, synthesize and present the best available evidence related to the safety of rapid rituximab infusion in adult non-Hodgkin lymphoma and chronic lymphocytic leukaemia patients. Data are from published and unpublished studies from electronic databases, grey literature and reference lists. The studies that met the inclusion criteria were critically appraised by two independent reviewers for methodological validity using standardized critical appraisal instruments. Proportional meta-analysis based on DerSimonian-Laird weights using a random effects model was used for statistical pooling through Stats Direct. Heterogeneity is assessed using Cochran Q. When statistical pooling is not possible, the findings were presented in narrative summary. Rapid rituximab infusion is safe for non-Hodgkin lymphoma patients at a 90 min regimen. However, there is insufficient evidence to support rapid rituximab infusions for chronic lymphocytic leukaemia patients.

Acute adverse reactions of rapid Rituximab infusion among adult patients with Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia.

BACKGROUND: Rapid Rituximab infusion has become increasingly popular globally. Although pharmaceutical manufacturers recommend second and subsequent infusions to run over 2-3 hours, many cancer centres have changed their clinical practice based on their own research and the results from other primary studies. Such research studies claim that it is safe to administer Rituximab rapidly among cancer patients especially in Non Hodgkin Lymphoma (NHL) and Chronic Lymphocytic Leukemia (CLL). In addition, the studies suggest that the rapid infusion of Rituximab also results in benefits of cost saving and better resource utilisation. However, these studies have not been critically appraised for their validity and application to the global population. No previous systematic reviews on this topic have been identified.Objective The objective of this review was to critically appraise, synthesise and present the best available evidence related to the safety of rapid Rituximab infusion among adult patients with NHL and CLL. INCLUSION CRITERIA: The participants of interest were adults aged 18 years old and above who had a diagnosis of NHL or CLL at any stage, have had prior exposure to Rituximab and received Rituximab with or without combination of any chemotherapy.The intervention of interest was rapid Rituximab infusion to be completed in 120 minutes or less.The studies of interest were both experimental and non-experimental studies.The primary outcomes of interest were the presence of acute adverse reactions and their severity. The secondary outcomes of interest were the management of the acute adverse reactions and patient mortality rate resulting from adverse reactions.Search strategy The search sought to identify published and unpublished studies from 1997 till 2010. A three-step search strategy was used for electronic databases, grey literature and reference lists.Methodological quality Two independent reviewers used the standard critical appraisal tool from JBI-MAStARI to assess the methodological qualities of the studies that matched with inclusion criteria.Data collection A standard data form from JBI-MAStARI was used to extract the data across all included studies.Data synthesis Proportional Meta-analysis based on DerSimonian-Laird weights for the random effects model was used for statistical pooling through Stats Direct. Heterogeneity was assessed using Cochran Q. When statistical pooling is not possible, the findings are presented in narrative summary. RESULTS: A total of 753 patients were included in this review. All except one patient completed a total of 2298 cycles of rapid Rituximab infusions. Seventeen and one acute adverse reactions were reported among NHL and CLL patients respectively. There were five reactions which were not clearly stated if they were occurring in NHL or CLL patients. All were mild to moderate reactions except one patient developed severe reaction and withdrew from the study. CONCLUSIONS: Rapid Rituximab infusion is safe for NHL patients especially in a 90-minute regimen. However, rapid rituximab infusion is not recommended for CLL patients due to lack of evidence. IMPLICATIONS FOR PRACTICE: 90-minute rapid Rituximab infusion with or without steroid premedication is recommended for NHL patient at second and subsequently infusions. No recommendations can be made in relation to stage of disease or the presence of bulky disease or leucocytosis. It is not recommended, based on the current evidence, to use rapid Rituximab for CLL patients. IMPLICATIONS FOR RESEARCH: Further research is needed on the role of monoclonal antibodies development in rapid infusion, especially in the second and subsequent cycles. Currently, this review broadly establishes that rapid Rituximab infusion over 90 minutes is safe for NHL patients. However, more research and detailed analysis is needed to develop more specific guidelines.

Measurement Accuracy of Non-invasively Obtained Central Blood Pressure: A Systematic Review and Meta-analysis.

BACKGROUND: Blood pressures determined at different sites vary considerably. Non-invasive methods are available to estimate central aortic blood pressure, the blood pressure at the origin of all arterial pulses. These methods obtain estimated central blood pressure by calibration and/or mathematical calculations for peripheral pulse waveforms. However, the accuracy of these methods has not been systematically examined. OBJECTIVES: The review aimed to synthesise the best evidence on the accuracy of non-invasive measurement methods for central blood pressure. INCLUSION CRITERIA: Types of participantsStudies with adult patients receiving invasive and non-invasive measurements of central blood pressure were considered. PHENOMENA OF INTEREST: Studies were considered for inclusion if the focus was accuracy of non-invasive central BP estimating methods compared to invasively obtained corresponding values. TYPES OF STUDIES: Studies examining agreement between measurements using non-invasive central blood pressure estimating methods compared to invasive corresponding values were considered. TYPES OF OUTCOMES: This review included the means and standard deviation of differences between estimated and invasively measured central blood pressure. SEARCH STRATEGY: The search sought to identify any relevant published or unpublished studies with a three-step search strategy. METHODOLOGICAL QUALITY: Two independent reviewers assessed methodological quality of studies by a critical appraisal tool modified from Cochrane Diagnostic Test Accuracy Working Group. DATA COLLECTION: We used an original form to extract from included studies all study characteristics possibly related to agreement. DATA SYNTHESIS: Inverse variance weighted approach and DerSimonian-Laird weights for the random effects model, which incorporates a between-study variance, were used to obtain pooled estimates of systematic and random error from individual study estimates of the mean and standard deviation of differences between the paired measurements. Heterogeneity was assessed using Cochran Q. All analyses were performed in Microsoft Excel 2003. RESULTS: Twenty eight studies were eligible for inclusion and critically appraised in this review. Appropriate data for agreement were extracted from papers or authors in 20 studies, which were further included in meta-analysis. Acquired peripheral waveforms in these studies were directly measured, calibrated to match invasively obtained aortic mean blood pressure and diastolic blood pressure, or calibrated using brachial blood pressure measured by sphygomomanometer, the cuff blood pressure. Estimated central blood pressure of the studies using the last totally non-invasively methods (real world practices) were subject to meta-analysis separately from studies with the former two invasive methods (theoretical practice). Of the invasive methods, mean difference of the estimated central blood pressure was small (-1.2 ± 4.2mmHg for central systolic blood pressure, -0.6 ± 2.1mmHg for central diastolic blood pressure, and -1.1 ± 5.3 mmHg for central pulse pressure). However, the errors of the non-invasive method inflated considerably (-8.1 ± 10.7mmHg for central systolic blood pressure, 8.8 ± 9.5mmHg for central diastolic blood pressure, and -11.8 ± 13.3 mmHg for central pulse pressure). The findings were similar in subgroup analysis by different central blood pressure methods and by validated cuff monitors. CONCLUSIONS: Current central blood pressure estimating methods are acceptable in theory with small systematic and random error. However, the error of these methods was evident when cuff blood pressure was used for calibration and probably made them clinically inapplicable.

The experience of being a neutropenic cancer patient in an acute care isolation room: a systematic review of qualitative evidence.

BACKGROUND: Protective isolation is one of the precautionary measures put in place for neutropenic cancer patients, where patients will be placed in an isolation room during their medical treatment in the hospital. The purpose of this practice is to minimise neutropenic patients from contracting nosocomial infection and the length of stay in the isolation room varies depending on their medical condition. It has been reported in some literature that this group of patients experience social isolation, a wide range of emotions and psychological burdens such as depression and anxiety as a result of staying in the isolation room. Therefore, a systematic review on neutropenic cancer patients' experience in isolation room will add knowledge to the nursing science of providing high quality care for this particular group of patients. OBJECTIVES: The objectives of this review are to understand neutropenic cancer patients' experiences in the isolation room and their coping mechanisms. INCLUSION CRITERIA: The participants of interest were adults neutropenic cancer patients aged 18 years old and above.The phenomenon of interest i was the experience of neutropenic cancer patients who were nursed in an isolation room due to chemotherapy induced neutropenia or during the period of haematopoietic stem cell transplant.The studies of interests were are qualitative studies which focus on adult neutropenic cancer patients' experiences in an isolation room.The outcome of interest wai s patients' self reported experiences. SEARCH STRATEGY: An initial search to identify keywords was undertaken in MEDLINE and CINAHL. A second search using all identified keywords and index terms across the databases was performed subsequently. The final search included reference lists from included papers for additional studies. METHODOLOGICAL QUALITY: Six qualitative papers were included in this review. The papers were qualitative descriptive, phenomenological, qualitative exploratory and grounded theory. All the papers used interview as primary method to collect data except one study which had an additional art making directive method. DATA COLLECTION: Data were extracted using standardised data extraction tools from JBI-QARI. DATA SYNTHESIS: Categories were formed based on aggregation from the similar findings with like meaning. The categories were then read and reread to develop two synthesised findings that were presented as declamatory and generalisable statements to guide and inform clinical practice. RESULTS: Two syntheses were generated based on the meta-aggregation. The first synthesis was that health care workers need to be aware physical isolation could result in social isolation in patients that made them feel powerless. The second synthesis was that health care workers should encourage patients to use cognitive mechanisms to cope with isolation experiences. Family, friends and nurses should step in to provide help in any form whenever patients need it. CONCLUSIONS: Isolation room has a negative impact on the neutropenic cancer patients while they are hospitalised. However, they are coping effectively using cognitive mechanisms and receive adequate support externally.Offering patients more options especially having flexibility in their daily routine such as meal times could be a useful intervention to allow them to take some control. Notifying the patient in advance of their time of treatment and involving patients in their treatment care will promote their autonomy. Tracking the patients' coping mechanisms and offering support when necessary will ease the patients' isolation experience.The psychological effects of being cared for in isolation room may undermine the clinical benefits of infection control. Therefore, future research is needed to evaluate the effectiveness of isolation room in preventing neutropenic cancer patients from infection.