安宁缓和医疗非药物干预改善老年癌因性疲乏

Hospice and palliative care non-pharmacological intervention improves cancer-related fatigue in the elderly

目的探讨安宁缓和医疗(HPC)非药物干预改善老年癌因性疲乏(CRF)的临床疗效及对生活质量的影响。方法本研究为单中心随机对照研究,选择2022年2月至2023年2月于浙江医院就诊的老年CRF患者40例,按照随机数字表法分为对照组和干预组各20例。两组患者均给予常规综合治疗,干预组在此基础上给予HPC非药物干预。连续治疗6周后比较两组的临床疗效、治疗前后CRF和生活质量的变化情况。结果两组患者基线资料比较,差异无统计学意义(均P>0.05)。治疗6周后,干预组患者在现在的疲乏程度、过去24 h的一般疲乏程度和最疲乏程度以及过去24 h疲乏对患者生活的影响(一般活动、情绪、行走能力、正常工作、与他人关系及享受生活)方面得分低于对照组(均P<0.01);干预组CRF临床缓解率为60%,对照组CRF临床缓解率为5%,干预组疗效优于对照组(P<0.01)。生活质量方面,干预组患者整体生活质量和情绪功能标准分上升(均P<0.01),而症状领域(疲乏、恶心呕吐、气促、睡眠障碍和食欲减退)标准分降低(均P<0.05)。结论HPC非药物干预可缓解老年CRF、提高患者生活质量,尤其是对老年CRF患者的整体生活质量、情绪功能、疲乏、恶心呕吐、气促、睡眠障碍和食欲减退等带来临床改善,是一项安全有效的治疗策略。

Objective To investigate the clinical efficacy of non-drug interventions in hospice and palliative care(HPC)for improving cancer-related fatigue(CRF)in elderly individuals and its impact on quality of life.Methods This study presents findings from a single-center randomized controlled trial conducted at Zhejiang Hospital,focusing on 40 elderly patients experiencing cancer-related fatigue(CRF)between February 2022 and February 2023.The participants were randomly assigned into a control group and an intervention group,each consisting of 20 individuals,using the random number table method.Both groups received routine comprehensive treatment,with the intervention group additionally receiving hospice and palliative care(HPC)non-drug intervention.Following 6 weeks of continuous treatment,the study compared the clinical efficacy,changes in CRF,and quality of life before and after treatment between the two groups.Results Comparing the baseline data of the two groups of patients,the difference was not statistically significant(all P>0.05).After 6 weeks of treatment,patients in the intervention group reported lower levels of current fatigue,general fatigue,worst fatigue in the past 24 hours,and impact of fatigue on various aspects of their lives compared to the control group(all P<0.01).The clinical remission rate of cancer-related fatigue(CRF)in the intervention group was 60%,significantly higher than the 5%in the control group(P<0.01).Additionally,the intervention group showed improvement in overall quality of life and emotional function with decreased symptom areas scores(fatigue,nausea and vomiting,shortness of breath,sleep disorders,and loss of appetite)(P<0.01 for quality of life and emotional function,P<0.05 for symptom areas).Conclusions Non-pharmacological interventions within the context of hospice and palliative care have been shown to alleviate cancer-related fatigue in elderly cancer patients,ultimately improving their quality of life.These interventions have demonstrated positive effects on various aspects such as overall quality of life,functional status,fatigue,nausea and vomiting,shortness of breath,sleep disorders,and decreased appetite.Furthermore,these interventions are considered safe and effective in the treatment of elderly cancer patients experiencing fatigue.