1 College of Nursing, Michigan State University, East Lansing, Michigan, USA ; 2 Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan, USA ; 3 Psychology Department, Michigan State University, East Lansing, Michigan, USA ; 4 Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA ; 5 Frederik Meijer Honors College, Grand Valley State University, Grand Rapids, Michigan, USA ; 6 West Michigan Cardiothoracic Surgeons, Grand Rapids, Michigan and College of Human Medicine, Michigan State University, East Lansing, Michigan, USA ; 7 School of Nursing, University at Buffalo, the State University of New York, Buffalo, New York, USA.
J Thorac Dis. 2014 Jun;6(6):632-40. doi: 10.3978/j.issn.2072-1439.2014.06.08.
Post-thoracotomy non-small cell lung cancer (NSCLC) patients report cancer-related fatigue (CRF) as a severe symptom that may increase the occurrence and severity of other symptoms while decreasing functional status and quality of life (QOL). The aim of this pilot study was to describe the effects of a home-based rehabilitative exercise intervention on CRF, other symptoms, functional status, and QOL for post-surgical NSCLC patients starting within days after hospital discharge.
Seven post-thoracotomy NSCLC patients completed the Brief Fatigue Inventory (BFI) measuring CRF severity, and the M.D. Anderson Symptom Inventory measuring symptom severity at pre- and post-surgery, and at the end of each week of the six-week intervention. Additionally, the Medical Outcomes Short-Form-36 measuring physical and mental functional status; and the Quality of Life Index (QLI) measuring QOL were completed pre- and post-surgery, after week 3, and at the end of the intervention (week 6).
Participants had a mean age of 65 years, a mean of 6 co-morbid conditions, and initiated the intervention within 4 days after hospital discharge. Participants' CRF severity scores were reduced to mild levels while the mean number of symptoms decreased from 10.4 post-surgery to 7.0 at week 6 with lower levels of severity and interference. Likewise, participants' post-intervention functional status and QOL improved to near or above pre-surgical levels.
The exercise intervention for post-surgical NSCLC patients showed promising preliminary efficacy in improving CRF, other symptom severity, functional status, and QOL. Further testing via a two-arm randomized controlled trial is being conducted.
开胸手术后非小细胞肺癌(NSCLC)患者报告癌症相关性疲劳(CRF)是一种严重症状,可能会增加其他症状的发生和严重程度,同时降低功能状态和生活质量(QOL)。本初步研究的目的是描述一种基于家庭的康复运动干预对术后 NSCLC 患者 CRF、其他症状、功能状态和 QOL 的影响,该干预在出院后几天内开始。
7 名开胸手术后 NSCLC 患者在术前、术后以及每周康复运动干预结束时完成简短疲劳量表(BFI)以评估 CRF 严重程度,完成 MD 安德森症状量表以评估症状严重程度,此外,患者还在术前和术后、第 3 周后以及干预结束时(第 6 周)完成医疗结局短式 36 量表以评估身体和精神功能状态;完成生活质量指数(QLI)以评估 QOL。
参与者的平均年龄为 65 岁,平均有 6 种合并症,并且在出院后 4 天内开始干预。参与者的 CRF 严重程度评分降至轻度水平,而术后平均症状数从 10.4 个减少到第 6 周的 7.0 个,症状严重程度和干扰程度均降低。同样,参与者的干预后功能状态和 QOL 也有所改善,接近或高于术前水平。
针对术后 NSCLC 患者的运动干预在改善 CRF、其他症状严重程度、功能状态和 QOL 方面显示出了有希望的初步疗效。目前正在进行一项双臂随机对照试验以进一步验证。