Du Qian, Chen Bo, Zhang Xiaohong, He Hong, Qin Xiaomin, Li Lin, Du Junyi, He Xindi, Xu Shaoyong, Xiaojie Huang
Department of Obstetrics and Gynecology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
BMJ Open. 2024 Jul 17;14(7):e078461. doi: 10.1136/bmjopen-2023-078461.
To assess the impact of a patient-based self-assessed fatigue intervention aimed at promoting early postoperative ambulation.
Prospective randomised controlled trial.
Single-centre, conducted at the Obstetrics and Gynaecology Department of the Xiangyang Central Hospital, China.
Eligible were adult patients undergoing elective gynaecologic oncologic surgery.
The intervention group utilised a modified Borg Rating of Perceived Experience (RPE) scale for self-assessment of fatigue levels. The control group followed fixed-activity distance guidelines postoperatively.
The primary outcome was the self-reported the time to first flatus postoperatively. Secondary outcomes encompassed the time to first defecation, incidence of moderate-to-severe abdominal distention, ileus, postambulation adverse events (nausea, vomiting and dizziness), patient satisfaction with early ambulation instructions, compliance with early ambulation and average hospital costs and length of stay.
Between June 2021 and October 2022, 552 patients were enrolled. The self-assessed fatigue intervention group demonstrated non-inferior the time to first flatus compared with the fixed-activity distance assessment group (25.59±14.59 hours vs 26.10±14.19 hours, p<0.001). Compliance with activity was higher in the intervention group (49.40% vs 36.02%, p<0.001), although it did not reach 50%. The intervention group also exhibited significantly higher mean hospital costs, length of stay and incidence of moderate-to-severe abdominal distention (p<0.001).
The self-assessed fatigue intervention for early postoperative ambulation in gynaecologic oncology patients shows promise as an effective strategy; however, compliance is suboptimal. An intervention based on mandatory, yet reasonable, fixed-activity distance may represent the most viable current approach. Further research is warranted to confirm these findings.
CTR2100046035.
评估以患者为基础的自我评估疲劳干预对促进术后早期活动的影响。
前瞻性随机对照试验。
在中国襄阳市中心医院妇产科进行的单中心研究。
符合条件的为接受择期妇科肿瘤手术的成年患者。
干预组采用改良的博格自觉运动强度（RPE）量表自我评估疲劳水平。对照组术后遵循固定活动距离指南。
主要结局是自我报告的术后首次排气时间。次要结局包括首次排便时间、中重度腹胀发生率、肠梗阻、活动后不良事件（恶心、呕吐和头晕）、患者对早期活动指导的满意度、早期活动的依从性以及平均住院费用和住院时间。
2021年6月至2022年10月期间，共纳入552例患者。自我评估疲劳干预组术后首次排气时间与固定活动距离评估组相比不劣（25.59±14.59小时 vs 26.10±14.19小时，p<0.001）。干预组的活动依从性更高（49.40% vs 36.02%，p<0.001），尽管未达到50%。干预组的平均住院费用、住院时间和中重度腹胀发生率也显著更高（p<0.001）。
妇科肿瘤患者术后早期活动的自我评估疲劳干预显示出作为一种有效策略的前景；然而，依从性欠佳。基于强制性但合理的固定活动距离的干预可能是目前最可行的方法。有必要进行进一步研究以证实这些发现。
CTR2100046035。
