乳腺癌幸存者治疗性运动和教育标准护理方案的设计与实施。
Design and implementation of a standard care programme of therapeutic exercise and education for breast cancer survivors.
机构信息
Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucia Tech, Málaga, Spain.
Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
出版信息
Support Care Cancer. 2022 Feb;30(2):1243-1251. doi: 10.1007/s00520-021-06470-9. Epub 2021 Aug 31.
BACKGROUND
Breast cancer survivors (BCS) face several symptoms and are at higher risk of weight gain following diagnosis. Current literature shows that both exercise and diet play a key role in recovery of BCS. However, there is a gap between current guidelines and the real-world context. The aim of this article is to describe the process behind a free, not-for-profit community-based therapeutic exercise and education programme (TEEP) for BCS in the clinical setting.
METHODS
The "Onco-Health Club" (OHC) consists of therapeutic exercise (TE) intervention aimed at ameliorating cancer-related fatigue (CRF) and improving QoL and physical function. TE is supplemented with nutritional education, providing information about the Mediterranean diet. To this end, patients are recruited from an oncologist and are referred to a physiotherapist and a nutritionist for baseline assessment. TEEP consists of a 3-month intervention, delivered twice a week in a group format with 1 h of TE and 30 min of nutritional education. BCS then have a final assessment and are advised to continue with a healthy lifestyle. Data about referral, compliance and assessment were collected.
RESULTS
From May 2017 to February of 2020, a total of 158 patients were recruited from 8 cohorts and 142 initially started the OHC. From 119 that joined the program, 96 patients were considered to have finished it with good adherence (assistance > 80%). BCS significantly improved their QoL, as well as upper and lower limb's function, and increased their level of physical activity. CRF tended to decrease (p = 0.005).
CONCLUSIONS
This study obtained data on recruitment, compliance, and possible limitations of these kinds of programmes in a real-world context. Further research is needed in order to optimize patient engagement and compliance, as well as to determine the transferability of these programmes in the clinical setting.
TRIAL REGISTRATION
NCT03879096, Registered 18th March 2019. Retrospectively registered.
背景
乳腺癌幸存者（BCS）在确诊后会面临多种症状，并面临更高的体重增加风险。目前的文献表明，运动和饮食在 BCS 的康复中都起着关键作用。然而，当前的指南与现实情况之间存在差距。本文的目的是描述在临床环境中为 BCS 提供免费、非营利性社区基础治疗性运动和教育计划（TEEP）背后的过程。
方法
“Onco-Health Club”（OHC）由旨在改善癌症相关疲劳（CRF）和提高生活质量和身体功能的治疗性运动（TE）干预组成。TE 辅以营养教育，提供有关地中海饮食的信息。为此，从肿瘤学家那里招募患者，并将他们转介给物理治疗师和营养师进行基线评估。TEEP 包括为期 3 个月的干预，每周两次以小组形式进行，每次 1 小时的 TE 和 30 分钟的营养教育。BCS 随后进行最终评估，并建议继续保持健康的生活方式。收集了有关转诊、依从性和评估的数据。
结果
从 2017 年 5 月至 2020 年 2 月，从 8 个队列中招募了总共 158 名患者，142 名患者最初开始参加 OHC。在参加该计划的 119 名患者中，有 96 名被认为完成了该计划，且依从性较好（辅助>80%）。BCS 显著改善了他们的生活质量，以及上肢和下肢的功能，并增加了他们的身体活动水平。CRF 有下降的趋势（p=0.005）。
结论
本研究在真实环境中获得了有关招募、依从性以及这些计划可能存在的局限性的数据。需要进一步研究，以优化患者的参与度和依从性，并确定这些计划在临床环境中的可转移性。
试验注册
NCT03879096，2019 年 3 月 18 日注册。回顾性注册。
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