Moy Sally, Kober Kord M, Viele Carol, Paul Steven M, Hammer Marilyn, Melisko Michelle, Wright Fay, Conley Yvette P, Levine Jon D, Miaskowski Christine
Author Affiliations: School of Nursing, University of California, San Francisco (Mss Moy and Viele and Drs Kober, Paul, and Miaskowski); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); School of Medicine, University of California, San Francisco (Drs Melisko and Levine); School of Nursing, New York University (Dr Wright); School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley).
Cancer Nurs. 2022;45(1):3-11. doi: 10.1097/NCC.0000000000000875.
Fatigue and sleep disturbance are common co-occurring symptoms in patients receiving chemotherapy. While the results from meta-analyses support the use of exercise to decrease the severity of these symptoms, information is needed on patients' "real world experiences" with the use of exercise.
The aims of this study were to determine distribution of patients who did and did not exercise on a regular basis and evaluate for differences in demographic and clinical characteristics, as well as the severity of fatigue, decrements in energy, and sleep disturbance among the exercise groups.
Patients (n = 1033) completed self-report questionnaires prior to their second or third cycle of chemotherapy. Patients were categorized into 3 exercise (Ex) groups (ie, NoEx, <150 min/wk [LessEx]; ≥150 min/wk [RecEx]). Differences among the groups were evaluated using parametric and nonparametric tests.
Only 19.1% of the patients were in the RecEx group. Patients in the NoEx group (37.2%) had fewer years of education, were more likely to be non-White and unemployed, had a higher body mass index, and a worse comorbidity profile. Patients in the NoEx group had higher levels of morning fatigue, lower levels of morning and evening energy, and higher levels of sleep disturbance.
Findings from this real-world study suggest that lack of physical activity is associated with higher levels of fatigue and sleep disturbance.
Given that the most frequently used intervention in this study was walking, clinicians can recommend this inexpensive intervention to patients to manage fatigue and sleep disturbance.
疲劳和睡眠障碍是接受化疗患者常见的并发症状。虽然荟萃分析结果支持通过运动来减轻这些症状的严重程度，但仍需要了解患者在运动方面的“实际体验”。
本研究旨在确定经常运动和不运动的患者分布情况，并评估运动组之间在人口统计学和临床特征方面的差异，以及疲劳严重程度、能量下降和睡眠障碍情况。
1033名患者在接受第二或第三个化疗周期之前完成了自我报告问卷。患者被分为3个运动（Ex）组（即不运动组、每周运动少于150分钟[较少运动组]、每周运动≥150分钟[规律运动组]）。使用参数检验和非参数检验评估组间差异。
只有19.1%的患者属于规律运动组。不运动组（37.2%）的患者受教育年限较少，更可能是非白人且失业，体重指数较高，合并症情况较差。不运动组患者早晨疲劳程度较高，早晨和晚上的能量水平较低，睡眠障碍程度较高。
这项实际研究的结果表明，缺乏身体活动与更高水平的疲劳和睡眠障碍有关。
鉴于本研究中最常用的干预措施是步行，临床医生可以向患者推荐这种低成本的干预措施来管理疲劳和睡眠障碍。
