乳腺癌化疗患者睡眠障碍非药物管理的最佳证据总结  

Best evidence summary for non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy

作　　者：李清扬 白怀毓 周忠涛 李烁烁 白茹[2] 张静 Li Qingyang;Bai Huaiyu;Zhou Zhongtao;Li Shuoshuo;Bai Ru;Zhang Jing(School of Nursing,Bengbu Medical College,Bengbu 233030,China;Department of Thyroid and Breast Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院护理学院,蚌埠233030 [2]蚌埠医学院第一附属医院甲乳外科,蚌埠233004

出　　处：《中华现代护理杂志》2024年第5期561-568,共8页Chinese Journal of Modern Nursing

基　　金：安徽省高等学校省级质量工程项目(2018jxtd105);安徽省高校自然科学研究重点项目(KJ2017A214)。

摘　　要：目的检索、评价并总结国内外关于乳腺癌化疗患者睡眠障碍非药物管理的最佳证据,为医护人员对乳腺癌化疗患者开展睡眠障碍规范化评估和管理提供循证依据。方法按照PIPOST模式将临床问题转化为循证问题,根据"6S"证据模型,系统检索国内外数据库和专业协会网站中与乳腺癌化疗患者睡眠障碍非药物管理有关的文献,包括临床决策、证据总结、指南及系统评价等。检索时限均为建库至2022年12月17日。由2名接受过循证护理系统培训的研究人员独立完成纳入文献的质量评价和证据提取及汇总。结果共纳入16篇文献,其中2篇临床决策、1篇证据总结、5篇指南、6篇系统评价、2篇随机对照研究。最终从多学科协作、危险因素识别、评估与监测、转诊、心理行为干预、运动管理、补充疗法7个方面总结了25条最佳证据。结论本研究总结目前关于乳腺癌化疗患者睡眠障碍非药物管理的最佳证据,医护人员可遵循最佳证据对患者睡眠障碍症状进行标准化评估,并根据临床情境和患者意愿选择合适的干预方案,以提高患者睡眠质量。Objective To retrieve,evaluate,and summarize the best domestic and international evidence on non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy,providing evidence-based guidance for healthcare professionals to conduct standardized assessment and management of sleep disorders in these patients.Methods Clinical questions were translated into evidence-based questions using the PIPOST model.A systematic search of domestic and international databases and professional association websites was conducted for literature related to non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy,including clinical decisions,evidence summaries,guidelines,and systematic reviews.The search covered publications up to December 17,2022.Two researchers trained in evidence-based nursing independently completed the quality assessment,evidence extraction,and summary of the included literature.Results A total of 16 publications were included,comprising two clinical decisions,one evidence summary,five guidelines,six systematic reviews,and two randomized controlled studies.The best evidence was summarized from seven aspects:multidisciplinary collaboration,identification of risk factors,assessment and monitoring,referral,psychological behavioral interventions,exercise management,and complementary therapies,resulting in 25 key recommendations.Conclusions This study summarizes the current best evidence for non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy.Healthcare professionals can follow these best evidence practices to standardize the assessment of patient sleep disorder symptoms and choose appropriate intervention plans based on clinical context and patient preferences,thereby improving patient sleep quality.

关 键 词：乳腺肿瘤 化疗 睡眠障碍 非药物管理 证据总结 循证护理学 

分 类 号：R473.73[医药卫生—护理学]