文献类型：期刊文献

中文题名：基于症状管理理论的癌症幸存者癌因性疲乏护理路径构建与实证研究

英文题名：Construction and Empirical Study of Cancer-Related Fatigue Nursing Path for Cancer Survivors Based on Symptom Management Theory

作者：曹文静[1];魏晓凤[1];余文娟[2];王鑫[1]

第一作者：曹文静

机构：[1]甘肃中医药大学附属医院肿瘤科,甘肃兰州730020;[2]甘肃中医药大学附属医院老年病科,甘肃兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2026

卷号：24

期号：11

起止页码：169

中文期刊名：中国医药指南

外文期刊名：Guide of China Medicine

基金：兰州市科技计划项目(2022-5-119);甘肃中医药大学附属医院院内创新基金项目(gzfy-2019-19)。

语种：中文

中文关键词：癌症幸存者;癌因性疲乏;症状管理理论;护士主导;中医外治;炎症因子

外文关键词：Cancer survivors;Cancer related fatigue;Symptom management theory;Nurse led;External treatment of traditional Chinese medicine;Inflammatory factors

摘要：目的本研究旨在创建一套护士主导的“i-CRF”多维度护理路径,以系统化解决癌症幸存者的癌因性疲乏问题,并验证其提升生活质量的临床效果。方法纳入2023年1月至2024年6月于甘肃中医药大学附属医院、甘肃省中医院及甘肃省肿瘤医院门诊随访的乳腺癌、结直肠癌术后1~5年幸存者180例,按随机数字表法分为干预组与对照组各90例。干预组实施为期6周的“i-CRF护理路径”,对照组接受常规健康教育手册及每月1次电话随访。于干预前(T0)、干预后6周(T1)及随访12周(T2)评估主要结局[12项疲乏量表简版(PFS-12)、简明疲乏量表(BFI)、6 min步行距离(6MWD)、手握力(HGS)]和次要结局[医院焦虑抑郁量表(HADS)、匹兹堡睡眠质量指数(PSQI)、白细胞介素-6(IL-6)与肿瘤坏死因子α(TNF-α)、欧洲癌症研究与治疗组织生活质量核心量表(EORTC QLQ-C30)]。结果组内比较提示,干预组在T1和T2时所有主要和次要结局指标均较T0改善(P<0.05),对照组仅BFI、PFS-12评分在T1、T2时较T0改善(P<0.05),其余指标与T0相比差异无统计学意义(P>0.05)。组间比较提示,在T1和T2时,干预组的PFS-12、BFI、HADS-A、HADS-D、PSQI评分及IL-6、TNF-α水平均低于对照组,6 MWD、HGS及EORTC QLQ-C30评分高于对照组(P<0.05)。两组不良事件发生率比较差异无统计学意义(P>0.05)。结论以症状管理理论为指导、护士主导的i-CRF多维度护理路径能有效且持续地减轻癌症幸存者的癌因性疲乏,改善其躯体功能、情绪、睡眠与生活质量,并有助于降低全身炎症水平。
Objective This study aims to create a set of nurse led“i-CRF”multi-dimensional nursing pathway to systematically solve the cancer-related fatigue of cancer survivors,and verify the clinical effect of improving the quality of life.Methods A total of 180 breast cancer and colorectal cancer survivors who had survived for 1 to 5 years after surgery and were followed up at the outpatient departments of Gansu University of Chinese Medicine Affiliated Hospital,Gansu Provincial Hospital of Traditional Chinese Medicine,and Gansu Provincial Cancer Hospital from January 2023 to June 2024 were included.They were random number table into the intervention group and the control group,with 90 cases in each group.The primary outcomes[12-item Fatigue Scale Short Form(PFS-12),Brief Fatigue Inventory(BFI),6-minute Walk Distance(6MWD),Handgrip Strength(HGS)]and the secondary outcomes[Hospital Anxiety and Depression Scale(HADS),Pittsburgh Sleep Quality Index(PSQI),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α),European Organization for Research and Treatment of Cancer Quality of Life Core Scale(EORTC QLQ-C30)]were evaluated before the intervention(T0),6 weeks after the intervention(T1),and at the 12-week follow-up(T2).Results The intra-group comparison indicates that in both T1 and T2,all the primary and secondary outcome indicators of the intervention group improved compared to T0(P<0.05).The only indicators in the control group that improved compared to T0 were BFI and PFS-12 scores at T1 and T2(P<0.05).The differences in the remaining indicators were not statistically significant(P>0.05).The inter-group comparison shows that at T1 and T2,the intervention group had lower PFS-12,BFI,HADS-A,HADS-D,PSQI scores,and IL-6 and TNF-αlevels than the control group,while 6 MWD,HGS,and EORTC QLQ-C30 scores were higher in the intervention group(P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusions The multi-dimensional nursing pathway of i-CRF guided by symptom management theory and led by nurses can effectively and continuously reduce cancer-related fatigue of cancer survivors,improve their physical function,mood,sleep and quality of life,and help to reduce the level of systemic inflammation.