造血干细胞移植患者疲乏管理的最佳证据总结

目的 检索、评价并总结国内外关于造血干细胞移植患者疲乏管理的最佳证据，为临床开展相关循证护理实践提供参考。方法 系统检索国内外计算机决策支持系统、指南网站、数据库、相关专业协会网站中关于造血干细胞移植患者疲乏管理的证据，包括指南、临床决策、推荐实践、证据总结、系统评价及专家共识。检索时间为建库至2022年2月10日。由2名研究者独立对文献质量进行评价，并结合专业判断进行资料提取、整合。结果 共纳入24篇文献，其中指南4篇、专家共识1篇、证据总结2篇、系统评价17篇。总结的最佳证据包括疲乏的评估、运动管理、心理社会干预、健康教育、营养管理、补充和替代疗法、合理用药、共同决策和多学科合作8个方面，共24条。结论 临床护理人员需要重视造血干细胞移植患者的疲乏管理，应根据临床实际情况和患者意愿，以规范、有效、安全的方式管理疲乏，以改善其预后和生活质量。

Summary of best evidence for management of fatigue in patients with hematopoietic stem cell transplantation

Objective To retrieve，evaluate and summarize domestic and foreign available evidence on the management of fatigue in patients with hematopoietic stem cell transplant（HSCT），so as to provide references for clinical evidence-based practice. Methods We systematically searched domestic and foreign computer decision support systems，guideline websites，databases，and relevant society websites for evidence on the management of fatigue in patients with HSCT，including guidelines，clinical decision-making，recommended practices，evidence summaries，systematic reviews，and expert consensuses published from the establishment of the databases or websites to February 10，2022. There were 2 researchers who evaluated the quality of the included literature independently，and combined the professional judgement with information extraction. Results A total of 24 pieces of literature were eligible for inclusion，including 4 clinical guidelines，2 evidence summaries，1 expert consensus and 17 systematic reviews. There were 24 pieces of best evidence with 8 dimensions being summarized，namely assessment，exercise management，psychosocial interventions，health education，nutritional therapy，complementary and alternative therapies，rational drug use，and shared decision-making and multidisciplinary collaboration. Conclusion Nursing staff should pay attention to the management of fatigue in patients with HSCT，and manage patients’ fatigue in a standardized，effective，and safe way according to characteristics of clinical environment and patients’ preferences，so as to improve their prognosis and quality of life.