College of Nursing, Pusan National University, Yangsan, Korea.
Cancer Nurs. 2011 Nov-Dec;34(6):E22-30. doi: 10.1097/NCC.0b013e31820d1734.
Radiotherapy can have multiple adverse effects, including patient complaints of persistent fatigue and low quality of life. Cognitive-behavior therapy (CBT) has alleviated fatigue and improved QOL of cancer patients; however, little is known about the effects of nurse-led CBT on breast cancer patients undergoing radiotherapy.
The purpose of this study was to analyze the effects of a nurse-led CBT program on fatigue and QOL of patients with breast cancer undergoing radiotherapy.
This study was performed using a quasi-experimental pretest/posttest design, with a nonequivalent control group. The participants were patients with breast cancer (N = 71: experimental group = 35, control group = 36) undergoing radiotherapy at P University Hospital in Korea. The experimental group received a 6-week intervention program that included cognitive restructuring, education about the disease and medical treatment, relaxation therapy, and rehabilitation exercise.
After the 6-week intervention, the level of fatigue increased in patients in both groups. However, the increase in the experimental group was lower than that in the control group. Quality of life of the experimental group was significantly higher than that of the control group.
The nurse-led CBT seemed to control fatigue level and improve QOL. Therefore, the use of nurse-led CBT for patients with breast cancer undergoing radiotherapy must be promoted.
Active involvement of experienced nurses in the counseling program should be considered. In addition, further research must be conducted into the implementation of the nurse-led cognitive-behavioral intervention to a broader spectrum of patients.
放射治疗会产生多种不良反应，包括患者持续疲劳和生活质量低下的抱怨。认知行为疗法（CBT）已减轻了癌症患者的疲劳并改善了其生活质量，但对于护士主导的 CBT 对接受放射治疗的乳腺癌患者的影响知之甚少。
本研究旨在分析护士主导的 CBT 方案对接受放射治疗的乳腺癌患者疲劳和生活质量的影响。
本研究采用了准实验前测后测设计，非对等对照组。参与者为在韩国 P 大学医院接受放射治疗的乳腺癌患者（N=71：实验组=35，对照组=36）。实验组接受了为期 6 周的干预方案，包括认知重构、疾病和医疗教育、放松疗法和康复运动。
在 6 周的干预后，两组患者的疲劳程度均有所增加。然而，实验组的增加幅度低于对照组。实验组的生活质量明显高于对照组。
护士主导的 CBT 似乎可以控制疲劳水平并提高生活质量。因此，必须推广使用护士主导的 CBT 来治疗接受放射治疗的乳腺癌患者。
应考虑让经验丰富的护士积极参与咨询方案。此外，必须对更广泛的患者实施护士主导的认知行为干预进行进一步研究。
