系统化护理干预对癌因性疲乏患者影响的Meta分析

摘要

目的系统评价系统化护理干预对癌因性疲乏（cancer-related fatigue，CRF）患者的影响。方法以“癌症”、“疲乏”、“系统化护理”等为关键词，计算机检索中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、维普数据库（VIP）及万方数据库，检索日期为数据库建立至2012年12月1日；纳入系统化护理干预 CRF患者的随机对照试验（RCT），由2名评价者独立评价纳入研究的质量并提取资料，并用 RevMan 5．0统计软件进行Meta分析。结果共纳入9篇文献，包括1042例CRF患者，所有研究均采用了随机对照的方法，但未明确是否采用分配隐藏或双盲。Meta分析结果显示，通过护理干预后，系统护理干预组无疲乏及轻度疲乏患者明显多于常规护理组，差异具有统计学意义（RR 合并＝4．72，P ＜0．01，95％CI ＝3．58～6．24）；系统化护理对CRF患者的生活质量的影响，与常规护理比较，差异具有统计学意义（RR 合并＝9．67，P ＝0．003，95％CI ＝3．30～16．04）；经干预后系统化护理组CRF患者的卡氏功能（KPS）评分明显低于常规护理组患者，差异具有统计学意义（RR 合并＝4．22，P＜0．01，95％CI ＝2．06～6．38）。结论针对CRF患者进行护理，系统化护理干预明显优于常规护理模式，可改善CRF患者疲乏状态、生活质量等。%Objective To evaluate the systematic nursing intervention on patients with cancer related fatigue(Cancer-related Fatigue CRF).Methods “Cancer”,“Fatigue”,“Systematic Nursing”as key words, computer retrieval Chinese Biomedical Literature Database (CBM),Chinese Journal Full-text Database (CNKI),VIP database(VIP)and Wanfang database,retrieve date established for the database to Decem-ber 1,2012;systematic nursing intervention in patients with CRF included randomized controlled trials (RCT),2 reviewers independently evaluated the quality of included studies and extracted data,and use RevMan 5.0 statistical software for Meta-analysis.Results A total of nine documents,including 1 042 pa-tients with CRF, all studies using a randomized controlled way, but was not clear whether to use allocation concealment or blinded.Meta-analysis showed that,through nursing intervention,the system nursing intervention group patients without fatigue and mild fatigue,significantly more than usual care group,the difference was statistically significant (RR combined=4.72,P <0.01,95%CI =3.58-6.24);systematic care for the quality of life in patients with CRF effects compared with usual care,the difference was statistically significant (RR combined=9.67,P =0.003,95%CI =3.30-16.04);through systematic care group after intervention Cartesian function in patients with CRF(KPS)score was significantly lower than usual care patients,the difference was statistically significant (RR combined=4.22,P <0.01,95%CI =2.06-6.38).Conclusion For patients with CRF for care,systematic nursing intervention was signifi-cantly better than the conventional model of care,which can improve fatigue in patients with CRF status, quality of life and so on.