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护士指导下的综合肿瘤学患者自我治疗:一项随机对照试验。

Nurse-guided patient self-treatment in integrative oncology: a randomized controlled trial.

机构信息

Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel.

Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Support Care Cancer. 2023 Mar 25;31(4):233. doi: 10.1007/s00520-023-07689-4.

Abstract

OBJECTIVE

Nurses are increasingly becoming involved in integrative oncology (IO) programs. This study examined the additive effect of nurse-provided guidance for self-administered IO therapies on cancer-related fatigue and quality of life (QoL).

METHODS

The study was randomized and controlled, enrolling patients undergoing active oncology treatment with IO interventions for fatigue and other QoL-related outcomes. IO practitioner guidance on self-treatment with manual, relaxation, and/or traditional herbal therapies was provided to patients in both the intervention and control arms. However, patients in the intervention arms also received additional guidance on self-treatment by IO-trained palliative care nurses. All participants were assessed for fatigue and QoL at baseline and at 24-h follow-up, using the Edmonton Symptom Assessment Scale (ESAS) and the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire tools.

RESULTS

Of 353 patients recruited, 187 were randomized to the intervention and 166 to the control group. Both groups had similar demographic and oncology-related characteristics. Patients in the intervention arm reported significantly greater improvement in ESAS scores for fatigue (p = 0.026) and appetite (p = 0.003) when compared to controls.

CONCLUSION

The addition of nurse-provided guidance on self-administration of IO treatments to that provided by IO practitioners further reduced short-term scores for fatigue and improved appetite. The relationship between palliative and IO-supportive cancer care requires further study.

摘要

目的

护士越来越多地参与肿瘤整合医学(IO)项目。本研究考察了护士提供的自我管理 IO 治疗指导对癌症相关疲劳和生活质量(QoL)的附加影响。

方法

该研究为随机对照试验,纳入接受 IO 干预以缓解疲劳和改善其他 QoL 相关结局的正在接受积极肿瘤治疗的患者。IO 从业者在干预组和对照组均为患者提供了关于自我治疗的手册、放松和/或传统草药疗法的指导。然而,干预组的患者还接受了 IO 培训的姑息治疗护士提供的关于自我治疗的额外指导。所有参与者在基线和 24 小时随访时使用 Edmonton 症状评估量表(ESAS)和自我评估关切和幸福感(MYCAW)问卷工具评估疲劳和 QoL。

结果

在招募的 353 名患者中,187 名被随机分配到干预组,166 名被分配到对照组。两组患者的人口统计学和肿瘤学特征相似。与对照组相比,干预组患者的 ESAS 疲劳和食欲评分显著改善(p=0.026 和 p=0.003)。

结论

与 IO 从业者提供的自我管理 IO 治疗指导相比,护士提供的自我管理 IO 治疗指导进一步降低了短期疲劳评分,并改善了食欲。姑息治疗与 IO 支持性癌症护理之间的关系需要进一步研究。

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