乳腺癌内分泌治疗患者运动依从性干预方案的构建  

Construction of an intervention program for exercise adherence in breast cancer patients with endocrine-therapy

作　　者：张中宁 李欣 沈傲梅 强万敏 ZHANG Zhongning;LI Xin;SHEN Aomei;QIANG Wanmin(Tianjin Medical University Cancer Institute&Hospital&National Clinical Research Center for Cancer&Tianjin's Clinical Research Center for Cancer&Key Laboratory of Breast Cancer Prevention and Therapy,Tianjin Medical University,Ministry of Education&Key Laboratory of Cancer Prevention and Therapy&Department of Nursing,Cancer Hospital,Tianjin Medical University,Tianjin 300060,China;School of Nursing,Tianjin Medical University,Tianjin 300070,China;School of Nursing,Peking University,Beijing 100191,China)

机构地区：[1]天津医科大学肿瘤医院国家恶性肿瘤临床医学研究中心天津市恶性肿瘤临床医学研究中心天津市肿瘤防治重点实验室乳腺癌防治教育部重点实验室天津医科大学肿瘤医院护理部,天津300060 [2]天津医科大学护理学院,天津300070 [3]北京大学护理学院,北京100191

出　　处：《护士进修杂志》2025年第8期811-818,共8页Journal of Nurses Training

基　　金：天津市医学重点学科(专科)建设项目(编号:TJYXZDXK-011A)。

摘　　要：目的 构建乳腺癌内分泌治疗(endocrine therapy, ET)患者运动依从性的干预方案。方法 基于阶段变化理论(stage of change theory, SCT),通过文献分析法系统回顾国内外相关文献,检索时间为建库至2023年11月19日。结合乳腺癌ET患者运动依从体验的质性访谈、课题小组讨论拟定乳腺癌ET患者运动依从性干预方案初稿;采用专家会议法修订完善干预方案,形成乳腺癌ET患者运动依从性干预方案终稿。结果 共检索出3 575篇文献,最终纳入并提取11篇文献的相关资料。经过深度访谈24例乳腺癌ET患者,提取出运动获益感、运动依从性的障碍与促进因素、运动行为改变的支持性需求3个主题6个亚主题。10名专家参加会议,专家权威系数(Cr)为0.94,专家对干预主题、干预内容的重要性和合理性赋值均数范围为3.80~5.00,变异系数(CV)均<0.25,肯德尔协调系数(Kendall′s W)分别为0.266、0.270(P<0.001)。构建的运动依从性干预方案包括5个干预模块(患者评估、通识健康教育、分阶段干预、讨论交流会、运动随访与监测)、7个干预主题、38个具体干预内容。结论 本研究构建的乳腺癌ET患者运动依从性干预方案具有一定的科学性和实用性,方案内容具有合理性和临床实用性,有利于指导临床实践。Objective To construct an intervention program for exercise compliance in breast cancer patients with endocrine therapy(ET).Methods Based on stage of changes theory(SCT),the relevant domestic and foreign literatures were systematically reviewed through the literature analysis method,and the retrieval time was from the establishment of the database to November 19,2023.The first draft of the exercise adherence intervention program for breast cancer patients with ET was constructed based on the qualitative interviews of the exercise compliance experience of breast cancer patients with ET and the discussions of the project group.The intervention plan was revised and improved by using the expert meeting method to form the final draft of the intervention plan for exercise compliance in breast cancer patients with ET.Results A total of 3,575 literatures were retrieved,and the relevant data of 11 literatures were finally included and extracted.After in-depth interviews with 24 breast cancer patients with ET,3 primary themes and 6 sub-themes were identified:Sense of benefits from exercise,obstacles and promoting factors of exercise adherence,and supportive needs for exercise behavior change.A total of 10 experts were enrolled.The expert authority coefficient was 0.94,the mean value assigned by expertsv for the importance and rationality of the intervention topic and intervention content ranges from 3.80 to 5.00,and the coefficient of variation was less than 0.25,and Kendall coordination coefficients were 0.266 and 0.270(P<0.001),respectively.The final intervention program included 5 intervention modules(patient assessment,general health education,phased intervention,group discussion and communication,exercise follow-up and monitoring),7 intervention topics,and 21 specific intervention contents.Conclusion The exercise compliance intervention program for breast cancer patients with ET is scientific and practical,and the content of the program is reasonable and clinically practical,which is conducive to guiding clinical prac

关 键 词：乳腺肿瘤 内分泌治疗 运动依从性 专家会议法 跨理论模型 护理 

分 类 号：R473.73[医药卫生—护理学]