乳腺癌幸存者睡眠障碍非药物预防及管理最佳证据总结

Summary of the best evidence for non⁃drug prevention and management of sleep disorders in breast cancer survivors

目的筛选、提取并归纳乳腺癌幸存者睡眠障碍非药物预防及管理的相关最佳证据,为乳腺癌幸存者进行睡眠管理提供相关实践依据。方法采用PIPOST模式构建循证问题。根据循证检索资源的“6S”模型,使用计算机对PubMed、BMJ Best Practice、JBI循证卫生保健中心、NICE、Web of Science、美国临床肿瘤学会(ASCO)、中国知网、万方等数据库进行文献检索,检索内容包括临床指南、专家共识、系统评价、随机对照试验、临床决策以及证据总结等。结果共计纳入文献13篇,其中包含临床指南2篇,专家共识2篇,系统评价3篇,随机对照试验6篇。最终从睡眠障碍筛查与评估、体育活动建议、正念训练治疗、认知行为干预、中医治疗以及睡眠卫生健康教育等6个维度总结了27条最佳证据。结论本研究总结的27条最佳证据能为乳腺癌幸存者进行睡眠管理提供实践依据,将证据与临床实际相结合有助于制定系统化、全面化、个体化的睡眠管理方案。

Objective To screen,extract and summarize the best evidence related to non‐drug prevention and management of sleep disorders in breast cancer survivors,providing a relevant practical basis for sleep management in breast cancer survivors.Methods The PIPOST model was used to construct evidence‐based questions.According to the"6S"model of evidence‐based search resources,computer‐aided literature search was conducted on PubMed,BMJ Best Practice,JBI Evidence‐Based Health Care Center,NICE,Web of Science,American Society of Clinical Oncology(ASCO),CNKI,and Wanfang Database.The search content included clinical guidelines,expert consensus,systematic evaluation,randomized controlled trials,clinical decision‐making,and evidence summary.Results A total of 13 references were included,including 2 clinical guidelines,2 expert consensus,3 systematic reviews,and 6 randomized controlled trials;27 pieces of evidence were summarized with 6 dimensions,i.e.,sleep disorder screening and evaluation,sports activity recommendations,mindfulness training treatment,cognitive behavioral intervention,traditional Chinese medicine treatment,and sleep hygiene and health education.Conclusions The 27 best evidences summarized in this study provides a relevant practical basis for sleep management of breast cancersurvivors,and it is helpful to combine the evidence with clinical practice in developing systematic,comprehensive and individualized sleep management programs.