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基于月度和周度预后的癌症患者呼吸困难管理护理实践:日本姑息护理护士的多中心横断面研究

Nursing Practices for Dyspnea Management in Patients with Cancer Based on Monthly and Weekly Prognoses: A Multi-Site Cross-Sectional Study of Palliative Care Nurses in Japan.

作者信息

Kako Jun, Morikawa Miharu, Kajiwara Kohei, Kobayashi Masamitsu, Kanno Yusuke, Nakano Kimiko, Matsuda Yoshinobu

机构信息

Graduate School of Medicine, Mie University, Tsu, Japan.

Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Palliat Med Rep. 2024 Oct 14;5(1):440-444. doi: 10.1089/pmr.2024.0058. eCollection 2024.

Abstract

BACKGROUND AND PURPOSE

Dyspnea in patients with terminal cancer worsens near death, necessitating effective nonpharmacological management. Despite guideline recommendations, detailed studies on nonpharmacological nursing practices are scarce. This study aimed to elucidate nursing practices for dyspnea in patients with cancer based on monthly and weekly prognoses.

METHODS

A multi-site cross-sectional study was conducted among nurses in 389 palliative care units in Japan. The study surveyed the frequency of direct care practices for dyspnea management (nurse-led intervention, multidisciplinary intervention, psychoeducational programs, breathing techniques, walking therapy, inspiratory muscle training, respiratory rehabilitation, yoga, acupressure, fan therapy, guided imagery, abdominal massage, aromatherapy, and a reduction in room temperature and humidity) in patients with cancer with monthly and weekly prognoses.

RESULTS

Of the 389 invited units, 162 participated. From these, 2448 registered nurses were invited and 539 (22.3%) responded. Almost similar nursing practices were provided regardless of patient prognosis. Nurse-led intervention was the most frequently practiced, followed by room temperature and humidity reduction, multidisciplinary intervention, and fan therapy. Yoga, respiratory rehabilitation, and acupressure were rarely practiced.

CONCLUSION

Nursing practices for dyspnea are similar, irrespective of prognosis. Nurse-led interventions, reducing room temperature and humidity, multidisciplinary intervention, and fan therapy are frequently used for dyspnea in patients with cancer. Future studies should evaluate the effectiveness of these nursing practices.

摘要

背景与目的

晚期癌症患者的呼吸困难在濒死时会加重,因此需要有效的非药物治疗。尽管有指南推荐,但关于非药物护理实践的详细研究却很匮乏。本研究旨在阐明基于月和周预后的癌症患者呼吸困难的护理实践。

方法

在日本389个姑息治疗病房对护士进行了一项多中心横断面研究。该研究调查了针对有月和周预后的癌症患者进行呼吸困难管理的直接护理实践的频率(护士主导的干预、多学科干预、心理教育项目、呼吸技巧、步行治疗、吸气肌训练、呼吸康复、瑜伽、指压、风扇疗法、引导意象、腹部按摩、芳香疗法以及降低室温与湿度)。

结果

在389个受邀病房中,162个参与了研究。从这些病房中,邀请了2448名注册护士,539名(22.3%)做出了回应。无论患者预后如何,所提供的护理实践几乎相似。护士主导的干预是最常实施的,其次是降低室温与湿度、多学科干预和风扇疗法。瑜伽、呼吸康复和指压很少实施。

结论

无论预后如何,呼吸困难的护理实践相似。护士主导的干预、降低室温与湿度、多学科干预和风扇疗法常用于癌症患者的呼吸困难。未来的研究应评估这些护理实践的有效性。

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Management of Dyspnea in Advanced Cancer: ASCO Guideline.晚期癌症呼吸困难的管理:ASCO 指南。
J Clin Oncol. 2021 Apr 20;39(12):1389-1411. doi: 10.1200/JCO.20.03465. Epub 2021 Feb 22.

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