| 200 | 0 | 46 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 基于症状管理理论(symptom management theory, SMT)构建乳腺癌患者内分泌治疗期间骨关节症状(aromatase inhibitor-associated musculoskeletal symptoms, AIMSS)运动干预方案。方法 于2024年3—8月，基于SMT,通过乳腺癌内分泌治疗相关AIMSS管理的证据总结，形成乳腺癌患者内分泌治疗期间AIMSS运动康复方案初稿，进一步邀请10名乳腺癌诊疗、护理、康复专家对方案初稿进行论证和修订，最终形成运动干预方案。结果 本研究基于SMT构建的AIMSS运动干预方案，包括运动的目标和原则、运动前评估、运动策略、运动内容、运动安全、效果评价在内的6项一级指标。专家权威系数为0.93,科学性、适宜性、可操作性和安全性4项指标的变异系数均为0.00～0.15。结论 本研究构建的乳腺癌患者内分泌治疗期间AIMSS运动干预方案具有合理性、适宜性、可操作性，可为患者进行自我管理提供初步参考依据，可进一步应用于临床实践。
Abstract：Objective To develop an exercise intervention program for managing aromatase inhibitor-associated musculoskeletal symptoms(AIMSS) in breast cancer patients undergoing endocrine therapy based on symptom management theory(SMT).Methods Using SMT as the framework, evidence related to managing AIMSS during endocrine therapy in breast cancer was summarized, and an initial draft of the AIMSS exercise rehabilitation program was developed. Ten experts in breast cancer diagnosis, treatment, nursing, and rehabilitation were invited to review and revise the draft, resulting in the finalized intervention program from march to August 2024. Results This study utilizes an AIMSS exercise intervention protocol deveploped through SMT included 6 primary components: Goals and principles of exercise, pre-exercise assessment, exercise strategies, exercise content, exercise safety, and outcome evaluation. The expert authority coefficient was 0.93. The coefficients of variation of the 4 project indicators of scientificity, suitability, operability, and safety all ranged from 0.00 to 0.15. Conclusion The developed exercise intervention program for managing AIMSS in breast cancer patients undergoing endocrine therapy is rational, suitable, and feasible. It provides a preliminary reference for patient self-management and has the potential for further clinical application.
[1] JOHNSSON A,VON WACHENFELDT A.Factors influencing adherence to adjuvant endocrine therapy after breast cancer surgery[J].Cancer Reports,2024,7(8):e2160.
[2] VISVANATHAN K,FABIAN C J,BANTUG E,et al.Use of endocrine therapy for breast cancer risk reduction:ASCO clinical practice guideline update[J].Journal of Clinical Oncology,2019,37(33):3152-3165.
[3] FORBES J F,SESTAK I,HOWELL A,et al.Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS):A double-blind,randomised controlled trial[J].The Lancet,2016,387(10021):866-873.
[4] SHEN S,UNGER J M,CREW K D,et al.Omega-3 fatty acid use for obese breast cancer patients with aromatase inhibitor-related arthralgia (SWOG S0927)[J].Breast Cancer Research and Treatment,2018,172(3):603-610.
[5] WINTERS-STONE K M,SCHWARTZ A L,HAYES S C,et al.A prospective model of care for breast cancer rehabilitation:Bone health and arthralgias[J].Cancer,2012,118(S8):2288-2299.
[6] YANG G S,KIM H J,GRIFFITH K A,et al.Interventions for the treatment of aromatase inhibitor-associated arthralgia in breast cancer survivors:A systematic review and meta-analysis[J].Cancer Nursing,2017,40(4):E26-E41.
[7] CHAN C W H,TAI D,KWONG S,et al.The effects of pharmacological and non-pharmacological interventions on symptom management and quality of life among breast cancer survivors undergoing adjuvant endocrine therapy:A systematic review[J].International Journal of Environmental Research and Public Health,2020,17(8):2950.
[8] LINDER L.Analysis of the UCSF symptom management theory:Implications for pediatric oncology nursing[J].Journal of Pediatric Oncology Nursing,2010,27(6):316-324.
[9] DODD M,JANSON S,FACIONE N,et al.Advancing the science of symptom management[J].Journal of Advanced Nursing,2001,33(5):668-676.
[10] 胡雁.症状科学的发展及研究趋势[J].护士进修杂志，2023,38(24):2209-2213.
[11] BROUWERS M C,KHO M E,BROWMAN G P,et al.AGREE II:Advancing guideline development,reporting and evaluation in health care[J].Journal de L'Association Medicale Canadienne,2010,182(18):E839-E842.
[12] 顾莺，张慧文，周英凤，等.JBI循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价[J].护士进修杂志，2018,33(8):701-703.
[13] 朱政，胡雁，周英凤，等.推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J].护士进修杂志，2020,35(11):996-1000.
[14] Cancer Australia.Guidance for the management of early breast cancer.Recommendations and practice points[EB/OL].(2020-09-01)[2024-08-22].https://www.canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/guidance-management-early-breast-cancer-recommendations-and-practice-points.
[15] MARSDEN J,MARSH M,RIGG A,et al.British Menopause Society consensus statement on the management of estrogen deficiency symptoms,arthralgia and menopause diagnosis in women treated for early breast cancer[J].Post Reproductive Health,2019,25(1):21-32.
[16] ABRAHAM J,CALDERA H,COLEMAN R,et al.Endocrine therapy and related issues in hormone receptor-positive early breast cancer:A roundtable discussion by the breast cancer therapy expert group (BCTEG)[J].Breast Cancer Research and Treatment,2018,169(1):1-7.
[17] 中国康复医学会肿瘤康复专业委员会，江苏省整合医学研究会.以功能障碍为中心的中国癌症患者运动康复专家共识[J].中国康复医学杂志，2023,38(1):1-7.
[18] 国家肿瘤质控中心乳腺癌专家委员会，北京乳腺病防治学会健康管理专业委员会.中国乳腺癌随诊随访与健康管理指南(2022版)[J].中华肿瘤杂志，2022,44 (1):1-28.
[19] 荆凤，王园园，邢唯杰，等.乳腺癌患者芳香化酶抑制剂诱导的骨关节症状预防和管理的证据总结[J].中华护理杂志，2023,58(7):808-815.
[20] LU G L,ZHENG J,ZHANG L.The effect of exercise on aromatase inhibitor-induced musculoskeletal symptoms in breast cancer survivors:A systematic review and meta-analysis[J].Supportive Care in Cancer,2020,28(4):1587-1596.
[21] ROBERTS K E,RICKETT K,FENG S,et al.Exercise therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer[J].Cochrane Database of Systematic Reviews,2020,1(1):CD012988.
[22] BOING L,DE CARVALHO SOUZA VIEIRA M,MORATELLI J,et al.Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy-A systematic review and meta-analysis[J].Maturitas,2020,141:71-81.
[23] KIM T H,KANG J W,LEE T H.Therapeutic options for aromatase inhibitor-associated arthralgia in breast cancer survivors:A systematic review of systematic reviews,evidence mapping,and network meta-analysis[J].Maturitas,2018,118:29-37.
[24] BAE K,LAMOURY G,CARROLL S,et al.Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients:A systematic review with network meta-analysis[J].Critical Reviews in Oncology/Hematology,2023,181:103898.
[25] SCRUTH E.Exercise therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer[J].Clinical Nurse Specialist CNS,2021,35(4):167-168.
[26] HADJI P,AAPRO M S,BODY J J,et al.Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer:Joint position statement of the IOF,CABS,ECTS,IEG,ESCEO,IMS,and SIOG[J].Journal of Bone Oncology,2017,7:1-12.
[27] ZHAO Y,TANG L W,SHAO J,et al.The effectiveness of exercise on the symptoms in breast cancer patients undergoing adjuvant treatment:An umbrella review of systematic reviews and meta-analyses[J].Frontiers in Oncology,2023,13:1222947.
[28] FORNUSEK C P,KILBREATH S L.Exercise for improving bone health in women treated for stages Ⅰ-Ⅲ breast cancer:A systematic review and meta-analyses[J].Journal of Cancer Survivorship,2017,11(5):525-541.
[29] ZHU X Y,LI Z,CHEN C,et al.Physical therapies for psychosomatic symptoms and quality of life induced by aromatase inhibitors in breast cancer patients:A systematic review and meta-analysis[J].Frontiers in Oncology,2021,11:745280.
[30] GRADISHAR W J,MORAN M S,ABRAHAM J,et al.Breast cancer,version 3.2024,NCCN clinical practice guidelines in oncology[J].Journal of the National Comprehensive Cancer Network,2024,22(5):331-357.
[31] 林方圆.基于“肝肾同源” 理论探讨乳腺癌芳香化酶抑制剂相关关节痛的影响因素及中药干预的临床研究[D].天津：天津中医药大学，2021.
[32] BROWN J C,MAO J J,STRICKER C,et al.Aromatase inhibitor associated musculoskeletal symptoms are associated with reduced physical activity among breast cancer survivors[J].The Breast Journal,2014,20(1):22-28.
[33] ROODMAN G D.Mechanisms of bone metastasis[J].New England Journal of Medicine,2004,350(16):1655-1664.
[34] BUZASI E,CARREIRA H,FUNSTON G,et al.Risk of fractures in half a million survivors of 20 cancers:A population-based matched cohort study using linked English electronic health records[J].The Lancet Healthy Longevity,2024,5(3):e194-e203.
[35] DOS SANTOS B S,BORDIGNON C,ROSA D D.Managing common estrogen deprivation side effects in HR+ breast cancer:An evidence-based review[J].Current Oncology Reports,2021,23(6):63.
[36] GOSS P E,INGLE J N,PRITCHARD K I,et al.Exemestane versus anastrozole in postmenopausal women with early breast cancer:Ncic ctg Ma.27—A randomized controlled phase Ⅲ trial[J].Journal of Clinical Oncology,2013,31(11):1398-1404.
[37] ISANEJAD A,NAZARI S,GHARIB B,et al.Comparison of the effects of high-intensity interval and moderate-intensity continuous training on inflammatory markers,cardiorespiratory fitness,and quality of life in breast cancer patients[J].Journal of Sport and Health Science,2023,12(6):674-689.
[38] ROBERTS K E,ADSETT I T,RICKETT K,et al.Systemic therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer[J].Cochrane Database of Systematic Reviews,2022,1(1):CD013167.
[39] FRANZOI M A,AGOSTINETTO E,PERACHINO M,et al.Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer[J].The Lancet Oncology,2021,22(7):e303-e313.
[40] 魏同群，王珂萌，朱景娜，等.“互联网+” 平台对乳腺癌患者芳香化酶抑制剂治疗全程骨健康管理的干预研究[J].中国实用护理杂志，2020,36(2):88-92.
[41] HIENSCH A E,DEPENBUSCH J,SCHMIDT M E,et al.Supervised,structured and individualized exercise in metastatic breast cancer:A randomized controlled trial[J].Nature Medicine,2024,30(10):2957-2966.
[42] KENNEDY M A,BAYES S,NEWTON R U,et al.We have the program,what now development of an implementation plan to bridge the research-practice gap prevalent in exercise oncology[J].The International Journal of Behavioral Nutrition and Physical Activity,2020,17(1):128.
基本信息:
DOI：10.16821/j.cnki.hsjx.2025.12.001
中图分类号:R473.73
引用信息:
[1]蒋凌云,荆凤,曹玉伶等.基于症状管理理论的乳腺癌患者内分泌治疗期间骨关节症状运动干预方案的构建[J].护士进修杂志,2025,40(12):1233-1240.DOI:10.16821/j.cnki.hsjx.2025.12.001.
基金信息:
国家自然科学基金面上项目(编号：82272922)