Application of stepped care model in cancer patients: a scoping review

To clarify the implementation steps, characteristics, effects, acceptability, and feasibility of the stepped care model (SCM) while also offering a resource for pertinent interventions in cancer care.

We searched the PubMed, Embase, CINAHL, Web of Science, the Cochrane Library, and PsycINFO databases from inception to October 22, 2023. Two key concepts were used: cancer and stepped care model. Two reviewers independently screened the articles and extracted data by repeatedly reading the abstracts and full texts. The included literature was analyzed according to the updated framework for scoping reviews proposed by the Joanna Briggs Institute (JBI).

A total of 14 studies were included. Most of the reviewed SCMs comprised two steps: self-management interventions in the first step and cognitive-behavior interventions in the second step. Most often, interventions were delivered electronically. The main applications of SCM included providing psychological support, treating insomnia and relieving cancer-related fatigue. SCM was effective in improving multiple outcomes for cancer patients with feasibility and acceptability.

SCM has a promising future and is applicable to oncology care. Further research on facilitators and barriers to the application of this model in cancer care is needed to enhance patients’ quality of life.