国内关于有氧运动对患者癌因性疲乏干预性研究的文献质量评价

目的分析国内有关有氧运动对肿瘤患者癌因性疲乏干预性研究的现状及文献质量。方法以"肿瘤OR癌症""有氧运动""癌因性疲乏OR疲乏"为检索词,对中国生物医学数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库(VIP)进行检索;纳入文献采用改良后的Jadad量表进行方法学质量评价,采用CONSORT声明2010版本对文献报告质量进行综合评价。结果共检索出18篇符合纳入及排除标准的文献,纳入文献方法学质量较低,只有1篇文献Jadad评分为3分,5篇为2分,其余均低于2分;纳入研究报告书写欠规范。结论有氧运动能缓解癌因性疲乏的严重程度,但运动方式缺乏规范性;相关研究方法学质量较低,研究报告书写欠规范。因此,应进一步寻找最佳运动方式,同时,重视方法学研究,改善文献书写质量。     

国内关于肿瘤化疗病人预期性恶心呕吐研究的文献分析

[目的]分析我国肿瘤化疗病人预期性恶心呕吐的研究状况,为今后的研究提供依据和方向。[方法]以"预期性恶心呕吐""胃肠道反应""化疗"为主题词,对中国期刊全文数据库(CNKI)、万方数据库、维普数据库(VIP)及中国生物医学数据库(CBM)关于肿瘤化疗病人预期性恶心呕吐研究的护理文献进行检索及分析。[结果]共检索出26篇有效文献;10篇干预性研究,干预方法涉及中医护理、心理护理及音乐疗法等;7篇描述性研究,主要是针对预期性恶心呕吐影响因素方面的调查与分析,其中以预期性恶心呕吐与心理状况的相关性研究为主;4篇护理综述,主要涉及预期性恶心呕吐的概念、影响因素及干预措施等的研究进展;5篇护理经验类文献,主要是针对预期性恶心呕吐护理经验的介绍。[结论]国内有关肿瘤化疗病人预期性恶心呕吐的相关护理研究文献较少,处于起步阶段;预期性恶心呕吐的发生受到多种因素的影响,其中心理因素在预期性恶心呕吐的形成过程中起着主要作用;鉴于预期性恶心呕吐的发生机制,护理干预起到非常重要的作用,今后应加强护理干预在预期性恶心呕吐中的应用。     

国内关于肿瘤化疗病人预期性恶心呕吐研究的文献分析

[目的]分析我国肿瘤化疗病人预期性恶心呕吐的研究状况,为今后的研究提供依据和方向。[方法]以“预期性恶心呕吐”“胃肠道反应”“化疗”为主题词,对中国期刊全文数据库（CNKI）、万方数据库、维普数据库（VIP）及中国生物医学数据库（CBM）关于肿瘤化疗病人预期性恶心呕吐研究的护理文献进行检索及分析。[结果]共检索出26篇有效文献;10篇干预性研究,干预方法涉及中医护理、心理护理及音乐疗法等;7篇描述性研究,主要是针对预期性恶心呕吐影响因素方面的调查与分析,其中以预期性恶心呕吐与心理状况的相关性研究为主;4篇护理综述,主要涉及预期性恶心呕吐的概念、影响因素及干预措施等的研究进展;5篇护理经验类文献,主要是针对预期性恶心呕吐护理经验的介绍。[结论]国内有关肿瘤化疗病人预期性恶心呕吐的相关护理研究文献较少,处于起步阶段;预期性恶心呕吐的发生受到多种因素的影响,其中心理因素在预期性恶心呕吐的形成过程中起着主要作用;鉴于预期性恶心呕吐的发生机制,护理干预起到非常重要的作用,今后应加强护理干预在预期性恶心呕吐中的应用。     

非药物干预对化疗所致恶心呕吐影响的系统评价再评价

目的 对化疗所致恶心呕吐的非药物干预措施进行系统评价再评价。方法 检索有关非药物干预防治化疗所致恶心呕吐的系统评价或Meta分析文献。检索数据库包括中国知网、万方全文数据库、维普全文数据库、中国生物医学文献数据库、Cochrane Library、卫生保健及护理学数据库(CINAHL)、Embase、Pubmed,检索时间为建库至2022年6月30日。筛选文献后,提取纳入文献的相关资料,并评价分析其方法学质量和证据质量。结果 共纳入19篇系统评价文献,其中中质量等级4篇,低质量等级8篇,极低质量等级7篇。文献共评价8种非药物措施的证据,其中穴位刺激对化疗所致恶心呕吐的积极影响最为显著。结论 通过对目前已发表的系统评价再评价发现,非药物干预可尝试作为临床或居家管理化疗所致恶心呕吐的辅助手段,其中穴位刺激可优先考虑。但纳入文献的方法学质量不高、证据等级偏低,其效果仍需进一步验证。     

我国干预性护理研究论文的质量评价

目的制订严格的质量评价标准,对我国内地干预性护理研究论文进行质量评价。方法检索我国内地干预性护理研究论文,阅读全文并按照质量评价标准进行评价。结果经过初筛,对4225篇期刊论文和179篇学位论文进行了严格的质量评价,纳入1257篇期刊论文和152篇学位论文,发现纳入论文中达标率较低的质量评价项目依次是盲法、样本流失的描述和随机分配。结论我国干预性护理研究论文的方法学质量和报告规范有待提高。     

护理干预对化疗预期性恶心、呕吐的影响

目的 评价护理干预对预期性恶心、呕吐的临床效果.方法 选取本院采用化疗方法治疗的肿瘤患者238例随机分为两组,每组119例.对照组仅给予肿瘤化疗常规护理,观察组在此基础上给予针对化疗预期性恶心、呕吐的护理干预措施,比较两组护理效果.结果 经过相应的临床护理干预后,观察组各评估情况改善程度均明显好于对照组,并且观察组护理效果总有效率为89.1%,明显高于对照组的67.2%,差异有统计学意义(P<0.05).结论 对出现预期性恶心、呕吐的肿瘤化疗患者采取合理的护理措施,能有效降低恶心、呕吐的发生率、发生程度及持续时间,改善患者临床症状,提高护理有效率,值得临床应用.     

非药物干预治疗化疗相关性恶心呕吐有效性的系统评价再评价

目的对非药物干预治疗化疗相关性恶心呕吐有效性的系统评价/Meta分析的方法学和结局指标质量进行再评价。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中关于非药物干预预防或治疗化疗相关性恶心呕吐疗效的系统评价/Meta分析, 检索时限均为建库至2021年5月。纳入文献采用系统评价方法学质量评价工具(AMSTAR 2)进行方法学质量评价, 纳入文献的结局指标采用证据质量评价工具进行证据分级。结果共纳入24篇文献, AMSTAR 2质量评价结果7篇为低级, 其余17篇均为极低级, 主要缺陷为缺乏前期研究设计方案、检索策略不全面、未提供排除文献清单以及未报告纳入研究资助来源等;结局指标的证据质量分级1个为高级, 7个为中级, 其余均为低级或极低级。结论非药物干预治疗化疗相关性恶心呕吐有效性的相关系统评价/Meta分析方法学质量以及证据强度普遍较低, 研究结果可靠性差, 未来需设计科学严谨的高质量随机对照试验和系统评价进一步对非药物干预的有效性进行验证。     

耳穴贴压缓解化疗致恶心、呕吐的文献分析

[目的]了解和分析我国中医护理技术耳穴贴压缓解肿瘤化疗所致恶心、呕吐干预性研究的现状及存在的问题,为今后的研究和临床工作提供依据和方向。[方法]以"恶心、呕吐""胃肠道反应""化疗""耳穴"为主题词,从中国期刊全文数据库(CNKI)、万方数据库、维普数据库及中国生物医学数据库(CBM)检索相关文献,采用EndNote X3软件查重,采用Excel软件进行统计分析。[结果]共检索出52篇有效文献;研究证实耳穴贴压能有效缓解化疗所致恶心、呕吐情况,但大部分文献未对恶心、呕吐进行分类,分别观察干预效果;耳穴贴压在选穴、按压频率、开始时间、疗程等方面缺乏统一标准;文献质量一般,未达到循证要求。[结论]耳穴贴压能有效缓解化疗所致恶心、呕吐已得到证实,但在文献质量及耳穴贴压标准化研究方面,可从严格的实验设计、客观的评价指标、标准实施方案等方面进行更深入研究。     

穴位刺激对化疗引起恶心呕吐的效果评价

目的 评价国内文献穴位刺激对化疗引起恶心、呕吐的效果.方法 计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方数据库、维普中文科技期刊全文数据库,纳入符合条件的随机对照试验(RCT),共纳入27个RCT.结果 Meta分析显示,与未进行穴位刺激相比,穴位刺激可降低化疗引起的急性呕吐的发生率.由于异质性,各研究关于穴位刺激对化疗引起恶心、延迟性呕吐的作用效果未能合并,各研究结论不一.16个RCT未能区分化疗引起恶心、呕吐的类型,而穴位刺激在观察期间是否能缓解化疗引起的呕吐症状,结论不一致.结论 穴位刺激可降低化疗引起急性呕吐的发生率.对急性恶心、延迟性恶心、呕吐、预期性恶心、呕吐的作用仍需高质量、设计严谨的临床试验来验证.     

预期性恶心呕吐患者性格特征的研究

目的通过性格测定把预期性恶心呕吐的易感性格人群筛查出来,采取不同的干预措施,降低预期性恶心呕吐的发生率,提高化疗患者的生活质量。方法采用艾森克个件问卷（EPQ）调查发生预期性恶心呕吐的患者性格特征,并进行干预前后的比较。结果研究组和对照组精神质（P）维度、效度最表（L）分差异无疑著性（P〈0．05）,神经质（N）、内一外倾（E）分有差异（P〈0．05）。两组干预后EPQ各因子分均下降,N因子差异有显著性意义（P〈0．05）,预期性恶心呕吐程度下降明显（P〈0．05）。结论预期性恶心呕吐患者具有焦虑、担忧、忧郁不乐、情感反应强烈等神经质,属情绪不稳定个性,根据艾森克个性问卷中各量表值,对预期性恶心呕吐患者进行心理及行为干预,降低预期性恶心呕吐患者的发生率。     

Effects of coping style and relaxation on cancer chemotherapy side effects and emotional responses

This study was designed to determine (a) the relationship of coping style to cancer chemotherapy side effects and (b) whether coping style moderated the impact of a relaxation intervention on anxiety, depression, and nausea associated with chemotherapy. Forty-eight cancer patients were assigned randomly to receive either progressive muscle relaxation training before chemotherapy (experimental group) or standard care (control group). Spearman correlations indicated that a "blunting" or distraction-oriented coping style was associated with less anticipatory anxiety, less depression, and less nausea during and after chemotherapy. Spearman correlations also indicated that a "monitoring" or information-gathering coping style was associated with more anticipatory anxiety, and more nausea before and during chemotherapy. Although there was a significant effect of the relaxation intervention on posttreatment nausea, there were no other between-group differences. The results did suggest, however, that relaxation was effective in reducing anticipatory anxiety among "blunters," but not "monitors," perhaps because relaxation is a distraction strategy and therefore is consistent with a blunting coping style. The effects of coping and relaxation on pretreatment anxiety may have important implications, because anxiety is a key factor in classic conditioning models of anticipatory nausea and vomiting.     

Acute and anticipatory emesis in breast cancer patients

A group of 90 breast cancer patients undergoing chemotherapy were assessed prospectively to estimate the prevalence of acute (post-treatment) and anticipatory emesis in the 1990s. For this purpose, two protocols of chemotherapy were analysed separately: cyclophosphamide/methotrexate/5-fluorouracil (CMF) and 5-fluorouracil/doxorubicin/cyclophosphamide (FAC). All patients were treated with antiemetic therapy, which included one corticoid plus ondansetron (in the FAC regimen), or one corticoid plus thiethylperazine (in the CMF regimen). For at least one cycle of chemotherapy 86.1% and 91.7% patients in the FAC protocol presented vomiting and nausea respectively; 11.1% had anticipatory vomiting and 30.6% had anticipatory nausea. In the CMF protocol, 79.6% had post-chemotherapy vomiting and 71.7% had post-chemotherapy nausea associated with at least one cycle. In this group, 7.4% had anticipatory vomiting and 16.6% had anticipatory nausea. A high proportion of patients suffered anticipatory anxiety in both groups (75% in FAC, 74.1% in CMF). The stimuli most frequently associated with the appearance of anticipatory emesis were olfactory stimuli and cognitive stimuli. In summary, as a result of the advances made in antiemetic control during the last decade, the severity of chemotherapy-induced emesis seems to have significantly decreased, but the prevalence of these symptoms along the course of the treatment still remains high.     

ABC情绪管理在预期性呕吐患者中应用

目的探讨发生预期性恶心、呕吐的患者在化疗期间的应对方式,通过ABC情绪管理,改善患者情绪状态及应对方式,为今后的心理护理给予指导。方法以30名发生预期性恶心、呕吐患者为研究对象,运用焦虑、抑郁自评量表及简易应对问卷测量患者的情绪及应对方式,运用ABC情绪管理对预期性恶心、呕吐的患者进行干预,形式为集体培训与沙龙交流,内容包括化疗与情绪的关系、ABC情绪机制、有关疾病及化疗相关知识、应对不良情绪的技巧及不良情绪自我分析。结果预期性恶心、呕吐的患者在情绪管理后焦虑、抑郁得分显著下降,恶心呕吐程度显著下降,应对方式在干预后,积极应对方式评分明显提高,差异有显著意义(P<0.05)。结论 ABC情绪管理有助于改良预期性呕吐患者的应对方式,改善患者的不良情绪,提高生活质量。     

Impact of nausea/vomiting on quality of life as a visual analogue scale-derived utility score

Pharmacoeconomic analysis is often based upon incremental cost per increase in survival (cost-effectiveness). Using this definition supportive care measures, which increase quality but not quantity of life, generate a zero denominator and cannot be directly compared with other components of health care cost. Cost-utility analysis, which measures incremental cost per increase in quality-adjusted life-years (QALY), where QALY=utility score x time at risk, addresses this problem, since successful supportive intervention increases the utility score and thus provides a finite denominator in QALY even when absolute survival is unchanged. However, utility scores for various supportive care modalities have not been well defined. As a pilot study to generate a first approximation of a utility score for nausea/vomiting, we used a rating scale technique and administered two visual analogue scale questions to 30 patients completing a cycle of chemotherapy. Patients rated their global quality of life during their previous cycle of chemotherapy with hypothetical absence or presence of nausea/vomiting as the only variable. The study population included 8 male and 22 female patients, with a median age of 56 years. The most common malignancies were breast cancer (8 patients), lung cancer (7 patients), and hematologic malignancies (7 patients). On a 100 mm visual analogue scale, the mean score for overall quality of life during chemotherapy was 79 mm without nausea/vomiting and 27 mm with nausea/vomiting (P<0.001, pairedt-test). The implied marked increase in utility with relief of nausea/vomiting suggests a significant impact on cost-utility analysis. Similar methodology could be used to estimate utility scores in other areas of supportive care.Presented in part at the 31st Annual Meeting of the American Society of Clinical Oncology, Los Angeles, California, 1995     

放松训练联合意象引导音频对淋巴瘤化疗患者影响的研究

目的 探讨放松训练联合意象引导音频干预对淋巴瘤化疗患者恶心呕吐、焦虑水平及生命质量的影响。方法 采用方便抽样法,选取2020年6月—12月在天津市某三级甲等肿瘤专科医院住院的淋巴瘤初治患者100例作为研究对象,通过随机数字表法将其随机分为试验组和对照组,每组50例。试验组在化疗常规护理基础上接受放松训练联合意象引导音频干预,对照组接受化疗常规护理,包括化疗宣教、准确执行标准化止吐方案以及化疗间歇期线上随访。两组分别于化疗前24 h,第1、3、6周期化疗后24 h、7 d、14 d,采用中文版恶心呕吐干呕症状评估量表（Index of Nausea and Vomiting and Retching,INVR）、焦虑自评量表（Self-Rating Anxiety Scale,SAS）、癌症患者生命质量测定量表（The Functional Assessment of Cancer Therapy-General,FACT-G）进行评定。结果 试验组第1、3、6周期化疗后24 h、7 d、14 d,INVR评分、SAS评分均低于对照组,FACT-G总分均高于对照组,差异有统计学意义（P&...     

心理干预对肺癌化疗患者呕吐及满意度的影响

目的 研究心理干预对减轻肺癌患者化疗期间恶心、呕吐的化疗反应及增加患者对护理满意度的作用。 方法 将2014年2月至2014年7月在本科室住院的102位接受化学药物治疗的肺癌患者,用随机的方法分成两组,其中51例设为对照组,在化学药物治疗时只接受常规护理,另外51例患者为实验组,在接受常规护理的基础上增加音乐疗法、冥想、访谈等心理干预方式。分别对比两组患者在接受化疗药物治疗时恶心、呕吐的发生率和对护理工作的满意度的评价。 结果 对肺癌化疗患者进行系统、细致的心理干预后患者在接受化疗时恶心、呕吐的发生率有明显的降低(P<0.05),患者对护理工作的满意度也明显提高(P<0.05)。 结论 心理干预可以减少肺癌患者化疗期间的恶心、呕吐的不良反应的发生,满意度也得到明显提高,更大程度上减轻患者痛苦,提高优质护理服务质量。     

国内护理干预对乳腺癌患者依从性影响文献的meta分析

目的 评价护理干预对乳腺癌患者化疗依从性、患肢功能锻炼依从性、减轻化疗不良反应及并发症发生率的影响。方法 通过在中国知网全文数据库、中国生物医学文献数据库、万方数据库、山西医科大学移动图书馆检索护理干预对乳腺癌患者依从性影响的随机对照实验的文献,由2名评价员独立检索、筛查文献、提取数据、评价纳入文献的方法学质量并交叉核对后,筛选出符合评价标准的文献,用RevMan 5.0软件进行meta分析。结果 共纳入8篇文献,累计病例732例。Meta分析结果显示,护理干预有助于提高乳腺癌患者化疗依从性[OR=5.79,95%CI(2.59,12.93),P<0.001];肢体功能锻炼依从性[OR=5.57,95%CI(2.59,11.99),P<0.001];减轻化疗引起的恶心、呕吐[OR=0.28,95%CI(0.12,0.68),P<0.005]、口腔溃疡[OR=0.18,95%CI(0.05,0.69),P=0.01]、降低静脉炎的发生率[OR=0.18,95%CI(0.04,0.85),P=0.03],而肢体肿胀发生率方面差异无统计学意义[OR=0.42,95%CI(0.12,1.41),P=0.16]。结论 护理干预能改善乳腺癌患者化疗、患肢功能锻炼依从性,减轻化疗不良反应及静脉炎的发生,从而提高患者的生存质量。     

Determinants of anticipatory nausea and anticipatory vomiting in adults receiving cancer chemotherapy.

There is a need for further empirical investigation of variables that may contribute to the occurrence of anticipatory nausea and/or anticipatory vomiting (AN/AV) in persons receiving cancer chemotherapy. The purpose of this study was to examine the relationship of AN/AV in adults receiving an initial course of cancer chemotherapy in an outpatient setting with the following set of variables: symptom distress, mood disturbance, stage of disease, sensitivity to conditioning cues, emetic potential of antineoplastic drugs, age, psychosocial stress, and ability to cope. Thirty-two percent of the sample developed anticipatory nausea. Multivariate statistics were used to examine the contribution of the variables to the prediction of AN/AV. Analysis of the data revealed that 53% of the variance accounted for was contributed by the following combination of variables: emetic potential of drug, level of symptom distress, mood disturbance, stress and ability to cope (p = .001). The total percentage of cases correctly classified was 88.3%. This combination of variables correctly classified 100% of patients who experienced anticipatory nausea (n = 15). Eighty-two percent of patients who did not experience anticipatory nausea and/or anticipatory vomiting (n = 28) were classified correctly.     

Predicting development of anticipatory nausea in cancer patients: prospective examination of eight clinical characteristics

An algorithm based on learning theory and previous research for predicting which cancer patients would develop nausea in anticipation of chemotherapy treatments was tested. Patients with four or more of the following eight characteristics after their first treatment were predicted to develop anticipatory nausea (AN) by their fourth chemotherapy treatment: experienced nausea and/or vomiting after first treatment; nausea after treatment described as "moderate, severe, or intolerable;" vomiting after treatment described as "moderate, severe, or intolerable;" less than 50 yr of age; a susceptibilty to motion sickness; feeling warm or hot all over after treatment; sweating following treatment; feelings of generalized weakness following treatment. The characteristics significantly predicted subsequent anticipatory nausea development (p less than .01) by their fourth treatment in 355 consecutive cancer patients. Results were independent of the type of cancer being treated. The accuracy of the prediction was less specific than prior research, 34% of patients predicted to develop AN did so, compared to 16% of the total sample. Results are consistent with a learned etiology for the development of anticipatory side effects and support the importance of predictive methodologies in investigating mechanisms of anticipatory nausea development.