基于循证和中医理念的乳腺癌化疗患者癌因性疲乏护理干预方案的构建  

Construction of nursing protocol for cancer-related fatigue in breast cancer patients undergoing chemotherapy based on evidence-based practice and theory of chinese medicine

作　　者：戴美芬 梁钰贞 杨静[1] 尤燕燕 杨清 昌广婷 区幸莹 黄传蔷 陈智星 区洁芬 DAI Mei-fen;LIANG Yu-zhen;YANG Jing;YOU Yan-yan;YANG Qing;CHANG Guang-ting;OU Xing-ying;HUANG Chuan-qiang;CHEN Zhi-xing;OU Jie-fen(The Sixth Affiliated Hospital of South China University of Science and Technology,Foshan 528000,China;School of Nursing,Guangdong Pharmaceutical University,Guangzhou 510000,China)

机构地区：[1]华南理工大学附属第六医院,广东佛山528000 [2]广东药科大学护理学院,广东广州510000

出　　处：《护理学报》2024年第15期34-39,共6页Journal of Nursing（China）

基　　金：佛山市科学技术局佛山市自筹经费类科技创新项目(编号:2220001004015)。

摘　　要：目的基于循证医学与中医理论的结合,构建针对乳腺癌化疗患者癌因性疲乏的护理干预方案,以改善患者癌因性疲乏、生活质量和健康状况。方法基于循证护理的方法,检索、评价、汇总国内外关于中医理念下乳腺癌化疗患者癌因性疲乏护理的最佳证据,构建中医理念的乳腺癌化疗患者癌因性疲乏护理干预方案基本框架。采用德尔菲专家咨询法对18名专家开展2轮函询,通过专家小组会议的形式进行第3轮意见征询,最终确定方案各级条目。方案包括乳腺癌疲乏筛查、健康教育、个性化疲乏管理等措施。结果本研究共18名专家全程参与2轮函询和1次专家小组会议,2轮函询问卷回收率均为100%,专家权威系数分别为0.86、0.86;Kendall’s W值分别为0.08(χ^(2)=19.89,P=0.13)、0.15(χ^(2)=90.99,P<0.001),经专家小组会议讨论,最终达成一致意见。结论基于循证医学与中医理念构建的乳腺癌化疗患者癌因性疲乏护理干预方案,能为临床护理工作提供参考和指导,有助于提高患者生活质量。Objective To develop a nursing protocol for cancer-related fatigue in breast cancer patients undergoing chemotherapy based on the combination of evidence-based medicine and traditional Chinese medicine(TCM)theory,and to improve patients'cancer-related fatigue,quality of life,and health.Methods Following the evidence-based nursing approach,the best evidence on TCM nursing for cancer-related fatigue in breast cancer patients undergoing chemotherapy was retrieved,evaluated,and summarized.Basic framework of nursing protocol for cancer-related fatigue in breast cancer patients undergoing chemotherapy was constructed based on TCM theory.Delphi method was used to conduct two rounds of survey among 18 experts,and an expert panel meeting was held to identify the items at each level of the protocol.The protocol included measures such as fatigue screening,health education,and personalized fatigue management.Results A total of 18 experts participated in two rounds of survey and one expert panel meeting.The response rate for both rounds of survey was 100%,and the expert authority coefficient was 0.86 and 0.86,respectively.Kendall's W value was 0.08(χ^(2)=19.89,P=0.13)and 0.15(χ^(2)=90.99,P<0.001),respectively.The final nursing protocol was developed through discussions in the expert panel meeting.Conclusion The nursing protocol for cancer-related fatigue in breast cancer patients undergoing chemotherapy constructed based on evidence-based medicine and TCM theory can provide reference and guidance for clinical nursing and help improve patients'quality of life.

关 键 词：乳腺癌 化疗 癌因性疲乏 中医护理 循证护理 

分 类 号：R473.73[医药卫生—护理学]