雄激素剥夺治疗期间保持强壮和健康。
Staying Strong and Healthy During Androgen Deprivation Therapy.
机构信息
Author Affiliations: University of Kansas School of Nursing (Drs Myers, Manson, and Maliski); University of Kansas School of Health Professions (Dr Billinger); and University of Kansas Medical Center (Drs Hamilton-Reeves and Parker), Kansas City.
出版信息
Cancer Nurs. 2024;47(1):43-55. doi: 10.1097/NCC.0000000000001151. Epub 2022 Dec 11.
BACKGROUND
Androgen deprivation therapy (ADT) for prostate cancer is associated with cardiovascular comorbidities and numerous adverse effects decreasing health-related quality of life. Both exercise and dietary interventions have shown promise in reducing ADT-related negative sequelae. However, feasibility for personalized combined exercise/nutrition/education interventions is not well established.
OBJECTIVE
The purpose of this randomized, controlled, mixed-methods pilot study was to evaluate the feasibility of a nurse-led, telephone-delivered education, exercise, and nutrition intervention, Staying Strong & Healthy, to minimize ADT-related cardiovascular/metabolic risks and symptoms.
METHODS
Staying Strong & Healthy involves individually tailored education, exercise (aerobic and resistance), and nutrition intervention delivered over 6 months and was compared with attention control. The primary quantitative outcome measure was change from baseline in low-density lipoprotein. Secondary outcomes included change in lipid levels (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides), fasting blood glucose, hemoglobin A 1c , health-related quality of life, and diet quality. Assessments were performed at baseline, 6 months, and 12 months.
RESULTS
Feasibility was demonstrated by low attrition rates and high participant satisfaction. No between-group differences were demonstrated in the cardiovascular/metabolic outcomes. Significant within-group improvements were noted for high-density lipoprotein and hemoglobin A 1c in the intervention group.
CONCLUSION
The study results indicate that participation in a personalized, nurse-delivered exercise, nutrition, and educational intervention is feasible and acceptable to men with prostate cancer receiving ADT.
IMPLICATIONS FOR PRACTICE
Future randomized controlled research powered to detect significant differences is needed to confirm the impact of the Staying Strong & Healthy intervention on reduction of the cardiovascular/metabolic impact of ADT for men with prostate cancer.
背景
前列腺癌的雄激素剥夺疗法（ADT）与心血管合并症和许多不良反应相关，这些不良反应降低了与健康相关的生活质量。运动和饮食干预已显示出降低 ADT 相关负面后果的潜力。然而，个性化的综合运动/营养/教育干预的可行性尚未得到很好的确定。
目的
本随机对照混合方法初步研究的目的是评估由护士主导、电话提供的教育、运动和营养干预措施（保持强壮与健康）的可行性，以最大程度地降低 ADT 相关的心血管/代谢风险和症状。
方法
保持强壮与健康包括个性化的教育、运动（有氧运动和抗阻运动）和营养干预，为期 6 个月，并与对照注意力进行比较。主要的定量结果测量是低密度脂蛋白从基线的变化。次要结果包括血脂水平（总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯）、空腹血糖、糖化血红蛋白 A1c 、健康相关生活质量和饮食质量的变化。评估在基线、6 个月和 12 个月进行。
结果
低退出率和高参与者满意度表明可行性。心血管/代谢结果在组间没有差异。干预组的高密度脂蛋白和糖化血红蛋白 A1c 均有显著的组内改善。
结论
研究结果表明，接受 ADT 的前列腺癌男性参与个性化、由护士提供的运动、营养和教育干预是可行且可接受的。
实践意义
需要进行未来的随机对照研究，以确定功率足以检测差异，从而确认保持强壮与健康干预对降低 ADT 对前列腺癌男性心血管/代谢影响的作用。
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