Hammer Marilyn J, Eckardt Patricia, Cartwright Frances, Miaskowski Christine
Marilyn J. Hammer, PhD, DC, RN, FAAN, is the Director, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, and Member of the Faculty, Medical Oncology, Harvard Medical School, Boston, Massachusetts. Patricia Eckardt, PhD, RN, FAAN, is Professor, Barbara H. Hagan School of Nursing and Health Sciences, Molloy College, Rockville Center, New York. Frances Cartwright, PhD, RN, AOCN, FAAN, is the Chief Nursing Officer and Senior Vice President, Department of Nursing, The Mount Sinai Hospital, and Associate Professor, Icahn School of Medicine at Mount Sinai, New York, New York. Christine Miaskowski, PhD, RN, FAAN, is Professor and Vice Chair for Research, Sharon Lamb Endowed Chair in Symptom Management Research, and American Cancer Society Clinical Research Professor, University of California, San Francisco.
Nurs Res. 2021 Jan/Feb;70(1):6-14. doi: 10.1097/NNR.0000000000000468.
Hyperglycemia may potentiate symptom experiences. Exercise is a nonpharmacological intervention that can potentially improve glycemic control and mitigate symptom experiences in patients undergoing chemotherapy for cancer.
The primary objective was to assess the feasibility of patients engaging in a walking exercise study for 6 months. We also evaluated the effects of a prescribed walking program on glycemic control and for changes over time in the severity of pain, fatigue, depression, and sleep disturbance in patients undergoing chemotherapy for breast, lung, gynecologic, or gastrointestinal cancer.
A randomized pilot intervention study was conducted to evaluate differences within and between a prescribed walking program intervention group and a control group. All patients were followed for 6 months, had glycosylated hemoglobin A1c measured at enrollment and 6 months, and completed symptom questionnaires at enrollment, 3 months, and 6 months. Data were analyzed using descriptive statistics and analysis of covariance.
Most of the patients who enrolled completed the 6-month study. The few who withdrew expressed feeling overwhelmed. The sample was predominately non-Hispanic White female patients with breast cancer with a normal-to-slightly-overweight body mass index. The intervention group had a slight decrease in glycosylated hemoglobin A1c at 6 months. In addition, at 6 months, compared to the control group, the intervention group had significantly less sleep disturbance and depression. No other within- or between-group differences were found.
It is feasible for patients undergoing chemotherapy to participate in a prescribed walking program. Exercise, such as walking, may decrease hyperglycemia and symptom severity. Additional research with larger samples is warranted.
高血糖可能会加重症状体验。运动是一种非药物干预措施，有可能改善血糖控制，并减轻癌症化疗患者的症状体验。
主要目的是评估患者参与为期6个月的步行运动研究的可行性。我们还评估了规定的步行计划对血糖控制的影响，以及对乳腺癌、肺癌、妇科癌或胃肠道癌化疗患者疼痛、疲劳、抑郁和睡眠障碍严重程度随时间的变化。
进行了一项随机试点干预研究，以评估规定的步行计划干预组和对照组内部及之间的差异。所有患者均随访6个月，在入组时和6个月时测量糖化血红蛋白A1c，并在入组时、3个月和6个月时完成症状问卷。使用描述性统计和协方差分析对数据进行分析。
大多数入组患者完成了为期6个月的研究。少数退出者表示感到不堪重负。样本主要是体重指数正常至略超重的非西班牙裔白人乳腺癌女性患者。干预组在6个月时糖化血红蛋白A1c略有下降。此外，在6个月时，与对照组相比，干预组的睡眠障碍和抑郁明显较少。未发现其他组内或组间差异。
化疗患者参与规定的步行计划是可行的。步行等运动可能会降低高血糖和症状严重程度。有必要进行更大样本的进一步研究。
