癌症患者癌因性疲乏运动管理的最佳证据总结

Summary of the best evidence for the exercise management of cancer-related fatigue in cancer patients

目的评价并整合癌症患者癌因性疲乏运动管理的最佳证据。方法采用PIPOST模式明确循证问题,确定检索策略以及纳入和排除标准。根据"6S"证据模型,检索UpToDate、BMJ Best Practice、澳大利亚乔安娜布里格斯循证卫生保健中心数据库、Cochrane Library、英国国家卫生与临床优化研究所指南库、美国国立综合癌症网络、国际指南协作网、加拿大医学会临床实践指南信息库、PubMed、Web of Science、Embase、CINAHL、中国知网、万方、维普网、中国生物医学文献数据库及专业协会平台关于癌症患者癌因性疲乏运动管理的临床决策、最佳临床实践、指南、系统评价及专家共识等。检索时限为建库至2022年1月31日。由3名研究者对文献进行质量评价以及证据的整理、评价、整合。结果共纳入20篇文献,其中临床决策1篇、指南4篇、证据总结2篇、系统评价10篇、专家共识3篇。从运动安全性和有效性、运动时机、运动评估、运动原则、运动方式、运动强度和持续时间、运动依从性、运动风险管理8个方面汇总了25条最佳证据。结论总结了有关癌症患者癌因性疲乏运动管理的最佳证据,为临床规范开展运动干预提供了循证证据支持和参考意见,建议医护人员在证据转化过程中根据临床具体情境和患者个体差异选择最佳证据,制订个性化的运动管理方案,以降低患者癌因性疲乏的水平。

Objective To evaluate and summarize the best evidence of exercise management of cancer-related fatigue in cancer patients.Methods Evidence-based questions were identified using the PIPOST model to determine retrieval strategies and inclusion and exclusion criteria.According to the"6S"evidence model,the clinical decision-making,best clinical practice,guidelines,systematic review and expert consensus on the exercise management of cancer-related fatigue in cancer patients were searched in UpToDate,British Medical Journal Best Practice,Joanna Briggs Institute Evidence-based Health Care Center Database,Cochrane Library,National Institute for Health and Clinical Excellence,National Comprehensive Cancer Network,Guidelines International Network,Canadian Medical Association:Clinical Practice Guidelines,PubMed,Web of Science,Embase,CINAHL,China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine disc and professional association platform.The retrieval time limit was from the establishment of the database to January 31,2022.Three researchers evaluated the quality of the literature and collated,evaluated and integrated the evidence.Results A total of 20 articles were included,including 1 clinical decision-making,4 guidelines,2 evidence summaries,10 systematic reviews,and 3 expert consensus.A total of 25 best evidences were summarized from 8 aspects,namely,safety and effectiveness of exercise,exercise timing,exercise evaluation,exercise principle,exercise mode,exercise intensity and duration,exercise compliance and exercise risk management.Conclusions The best evidence on the exercise management of cancer-related fatigue in cancer patients provides evidence-based evidence support and reference opinions for clinical standardized exercise.It is suggested that medical and nursing staff should select the best evidence according to the specific clinical situation and individual differences of patients in the process of evidence transformation,and formulate a personalized exercise management plan to alleviate the cancer-related fatigue of patients.