運動是否可降低接受化學治療乳癌病人的癌因性疲憊?Can exercise reduce cancer-related fatigue in breast cancer patients with chemotherapy?

2062 3 309         DOI:doi.org/10.30131/TWNA_EBHC_Library.DB_2020110004B/Text

2021-02-23 已刊登
綜 整 預防/治療/介入類型

作  者

侯宜均* 高玉鳳

文章類別

B 類:實證健康照護應用

問題類型

治療/預防性問題

健康狀況

腫瘤醫學 (Oncology)  

治療/介入措施

其他(Others) - 運動

專長類別

腫瘤及安寧/緩和

中文關鍵詞

#運動 #癌因性疲憊 #乳癌

英文關鍵詞

#exercise # cancer related fatigue # breast cancer

機構名稱

長庚醫療財團法人林口長庚紀念醫院

申請單位

腫瘤科病房

中文摘要

形成臨床提問:
形成臨床提問-探討透過運動是否可降低接受化學治療乳癌病人的癌因性疲憊。PICO- P:45歲、女性、診斷乳癌、接受化學治療; I:運動;C:無運動;O:癌因性疲憊指數。
文獻搜尋的方法與分析:
(一) 文獻搜尋資料庫包含:PubMed、Embase、CEPS華藝、Cochrane。 (二) 關鍵字包含:P(breast cancer, Breast neoplasm、breast carcino*)、I(Exercise, Sport)、O(Cancer-related fatigue, fatigue);使用布林字元中的OR、AND進行分層搜尋,以統合分析及系統性文獻回顧文章為主。
文獻的品質評讀與結果:
文獻的品質評讀-搜尋結果:中英文文獻共113篇,排除不符合PICO主題 108篇,證據等級低1篇,重複1篇,剩3篇文獻評讀。採用2018年版CASP作為實證品質評讀工具。
證據之臨床應用:
證據之臨床應用-運用實證知識轉譯的7步驟進行改善。本研究設計為真實驗研究(隨機實驗控制組前後測),收案期間為2020年9月證據之臨床應用-運用實證知識轉譯的7步驟進行改善。本研究設計為真實驗研究(隨機實驗控制組前後測),收案期間為2020年9月1日至同年11月01日,研究對象採立意取樣,針對北部某醫學中心病房之接受化學治療乳癌病人進行收案,介入措施為實施快走運動方案。
成效評值:
以統計分析方式,比較前後測對照運動對接受化學治療乳癌病人的癌因性疲憊緩解成效。自研究介入後,共收案10位接受化學治療乳癌病人,分析結果:癌因性疲憊分數對照組由介入前5.82分降為4.4分,共降低1.42分;實驗組由介入前5.66分降為2分,共降低3.66分,比較實驗組的疲憊改善程度差異大於對照組,代表快走運動可顯著降低接受化學治療乳癌病人的癌因性疲憊。
結論與建議:
本文探討運動是否可降低接受化學治療乳癌病人的癌因性疲憊,透過實證手法進行文獻評讀,篩選最終介入策略後進行臨床應用。結果發現:快走運動可顯著降低接受化學治療乳癌病人的癌因性疲憊,與文獻所提結果一致。成效維持:本病房內病人自行形成快走團體,於固定時段在病房走廊相約運動,來促進情誼及維持健康。期望藉此拋磚引玉,鼓勵腫瘤科病房將快走運動計畫納入常規治療活動中,有效降低癌症病人的癌因性疲憊。

英文摘要

Ask an answerable question (PICO):
Build up a clinical question: explore whether doing exercise is able to reduce cancer-related fatigue in breast cancer patients with chemotherapy. PICO: P: 45 years old, female, diagnosed with breast cancer patients, chemotherapy; I: does exercise; C: no exercise; O: cancer-related fatigue score.
The Method and Analysis of Literature Review:
(1) The literature searching database includes : Cochrane, Embase, Airiti Library, and the Cochrane. (2) Keywords are included as follows: P (breast cancer, Breast neoplasm, breast carcino*), I (Exercise, Sport), O (Cancer-related fatigue, fatigue); Using OR, AND in Boolean Logic to develop strategy to search, Based on meta-analysis, systematic review articles.
Critical Appraisal:
Qualified critical appraisal of literature-for searching results: there are total 113 articles found in Chinese and English literature databases; by deducting and removing the literature of 108 articles measures of study design do not correspond with PICO, 1 articles were lower grade, 1 articles were repeat, a total of 3 articles of literature are being appraised, with the appraising tool of CASP in the version of 2018.
Clinical Application of Evidence:
Using 7 steps of empirical knowledge translation to improve the question. This research is designed as a true experimental research (random experimental control group before and after testing). During September 1, 2020 to November 1, 2020. Purposive sampling study, conducted for breast cancer patients with chemotherapy; Performed in the ward of the Northern Medical Center in Taiwan. Intervention measures for the implementation of speed walking exercise program.
Evaluation of Effectiveness:
Evaluation with the use of statistical analysis, compare the effectiveness of cancer-related fatigue changes before and after doing exercise in breast cancer patients with chemotherapy. Since research intervention, by statistically verified the 10 cases of new patients received, the result is indicated as: The cancer-related fatigue score of the control group decreased from 5.82 points before intervention to 4.4 points, a total decrease of 1.42 points; the experimental group decreased from 5.66 points before intervention to 2 points, a total decrease of 3.66 points. The cancer-related fatigue degree of the experimental group was greater than that of the control group. It means that speed walking can significantly reduce cancer-related fatigue in breast cancer patients with chemotherapy.
Conclusions and Recommendations:
This article is aimed to whether doing exercise is able to reduce cancer-related fatigue in breast cancer patients with chemotherapy? The results found that: speed walking exercise can significantly reduce cancer-related fatigue in breast cancer patients with chemotherapy, which is consistent with the results mentioned in the literature. Effectiveness maintenance: The patients in this ward form a speed walking group by themselves, and meet in the corridor of the ward to exercise at a fixed time to promote friendship and maintain health. It is hoped that this will help us to encourage the oncology ward to incorporate exercise plans into routine treatment activities to reduce cancer-related fatigue of cancer patients.