造血干细胞移植患者疲乏管理的最佳证据总结

Summary of best evidence for management of fatigue in patients with hematopoietic stem cell transplantation

目的检索、评价并总结国内外关于造血干细胞移植患者疲乏管理的最佳证据,为临床开展相关循证护理实践提供参考。方法系统检索国内外计算机决策支持系统、指南网站、数据库、相关专业协会网站中关于造血干细胞移植患者疲乏管理的证据,包括指南、临床决策、推荐实践、证据总结、系统评价及专家共识。检索时间为建库至2022年2月10日。由2名研究者独立对文献质量进行评价,并结合专业判断进行资料提取、整合。结果共纳入24篇文献,其中指南4篇、专家共识1篇、证据总结2篇、系统评价17篇。总结的最佳证据包括疲乏的评估、运动管理、心理社会干预、健康教育、营养管理、补充和替代疗法、合理用药、共同决策和多学科合作8个方面,共24条。结论临床护理人员需要重视造血干细胞移植患者的疲乏管理,应根据临床实际情况和患者意愿,以规范、有效、安全的方式管理疲乏,以改善其预后和生活质量。

Objective To retrieve,evaluate and summarize domestic and foreign available evidence on the management of fatigue in patients with hematopoietic stem cell transplant(HSCT),so as to provide references for clinical evidence-based practice.Methods We systematically searched domestic and foreign computer decision support systems,guideline websites,databases,and relevant society websites for evidence on the management of fatigue in patients with HSCT,including guidelines,clinical decision-making,recommended practices,evidence summaries,systematic reviews,and expert consensuses published from the establishment of the databases or websites to February 10,2022.There were 2 researchers who evaluated the quality of the included literature independently,and combined the professional judgement with information extraction.Results A total of 24 pieces of literature were eligible for inclusion,including 4 clinical guidelines,2 evidence summaries,1 expert consensus and 17 systematic reviews.There were 24 pieces of best evidence with 8 dimensions being summarized,namely assessment,exercise management,psychosocial interventions,health education,nutritional therapy,complementary and alternative therapies,rational drug use,and shared decision-making and multidisciplinary collaboration.Conclusion Nursing staff should pay attention to the management of fatigue in patients with HSCT,and manage patients’fatigue in a standardized,effective,and safe way according to characteristics of clinical environment and patients’preferences,so as to improve their prognosis and quality of life.