乳腺癌放化疗患者癌因性疲乏运动干预最佳证据总结

Best evidences of exercise interventions for cancer-related fatigue in patients undergoing radiochemotherapy for breast cancer

目的总结乳腺癌放化疗患者癌因性疲乏(cancer related fatigue,CRF)运动干预的最佳证据,为临床护理提供循证依据。方法检索UpToDate、BMJ Best practice、Cochrane Library、PubMed、美国国家综合癌症网络、加拿大安大略注册护士协会、苏格兰院际指南网、美国临床肿瘤协会、美国肿瘤护理协会、安大略省癌症护理中心、美国运动医学会、美国国立指南网、欧洲肿瘤内科学会、医脉通、JBI循证卫生保健国际合作中心图书馆、中国知网、万方、维普等网站和数据库中关于乳腺癌放化疗患者癌因性疲乏运动干预的临床指南、临床决策、系统评价、证据总结、专家共识、原始研究。检索时限为建库至2021年11月。结果共纳入文献12篇,其中临床实践指南3篇、临床决策1篇、系统评价8篇。总结最佳证据21条,包括运动前评估、运动时机、运动形式、运动强度、运动效果、运动方案制定原则、注意事项7个方面。结论乳腺癌放化疗患者CRF运动干预最佳证据可为临床应用提供循证依据,护理人员可根据证据进行临床护理实践。

Objective To summarise the best evidence of exercise interventions for cancer-related fatigue in patients undergoing radiochemotherapy for breast cancer hence to provide evidences for evidence-based clinical nursing.Methods Eighteen major databases were searched,from the inception of the databases to November 2021,for literatures including guidelines,clinical decisions,systematic reviews,evidence summaries and expert consensus about exercise interventions of cancer-related fatigue in patients undergoing radiochemotherapy for breast cancer.The searched databases included UpToDate,BMJ Best Practice,the Cochrane Library,PubMed,National Comprehensive Cancer Network(NCCN),Registered Nurses’Association of Ontario(RNAO),Scottish Intercollegiate Guidelines Network(SIGN),American Society of Clinical Oncology(ASCO),the Oncology Nursing Society(ONS),Cancer Care Ontario(CCO),the American College of Sports Medicine(ACSM),National Guideline Clearinghouse(NGC),European Society for Medical Oncology(ESMO),Medlive,Joanna Briggs Institute(JBI),CNKI,Wanfang Data and VIP.According to the established principles and procedures,quality evaluation,evidence extraction,and synthesis of literatures were carried out.Results A total of 12 papers were included,covering 3 guidelines for clinical practice,1 clinical decision and 8 systematic reviews.Twenty-one items of best evidences were summarised under 7 categories:pre-exercise assessment,timing,form,intensity and effect of exercise,principles for development of exercise program and precautions in exercise.Conclusions The best evidences summarised in this study provide an evidence-based clinical nursing for exercise interventions in cancer-induced fatigue of patients who are undergoing radiochemotherapy for breast cancer.Evidence-based clinical nursing could be conducted in nursing practices according to the summarised evidences.