探討運動方案改善晚期肺癌病人癌因性疲憊及症狀困擾之成效

Effect of an Exercise Program on Cancer-Related Fatigue and Symptom Disturbance Alleviation in Patients with Advanced Lung Cancer

黃秀霖(Hsiu-Lin Huang) ； 郭鳳霞(Foung-Shia Kou) ； 樊君儀(Chun-I Fan) ； 廖淑貞(Shu-Chen Liao) ； 洪世欣(Shih-Hsin Hung)

《榮總護理》 36卷2期 (2019/06) Pp. 178-190

https://doi.org/10.6142/VGHN.201906_36(2).0008

摘要

癌因性疲憊（Cancer-related fatigue，以下簡稱CRF） 存在於癌症的各階段病程，是最常見的症狀困擾，實證研究證實運動可有效改善CRF，唯晚期肺癌病人深受疾病所苦，需審慎設計適合的運動計畫以助益病人，故引發動機欲研擬本土化之實證應用研究以探討成效。本研究採隨機對照研究，期探討運動介入對晚期肺癌病人CRF、症狀困擾及活動耐力的改善成效，於北部某醫學中心收案54名肺癌治療中病人，研究期間因病情進展或死亡而流失17名（33.3%），實驗組（19名）接受專為晚期肺癌病人設計之運動方案，對照組（18名）維持原居家活動型態，持續追蹤八週。藉由運動日誌觀察活動情形及運動堅持度，以台灣版簡明疲憊量表（BFI-Taiwan Form）、安德森症狀量表（MDASI-Taiwan Form） 及六分鐘走路距離進行評估。研究資料以描述性及推論性統計分析，結果發現兩組前測僅年齡達顯著差異（p ＜ .05），以廣義估計方程式（Generalized Estimating Equation, GEE）統計檢定後，實驗組介入八週運動之後，疲憊、疲憊對生活干擾、症狀困擾、與六分鐘走路距離等均較對照組有改善，但未達顯著差異，僅症狀困擾對生活的妨礙程度較對照組有顯著下降（p ＜ .05），且實驗組介入前後之六分鐘走路距離已達最小臨床重要差異（Minimal Clinical Importance Difference, MCID），顯示運動方案可有效降低晚期肺癌病人的症狀困擾對生活妨礙程度，並增進活動耐力，可提供照護團隊臨床應用參考。

關鍵字

肺癌 ； 運動方案 ； 癌因性疲憊 ； 症狀困擾

並列摘要

Cancer-related fatigue (CRF), a common symptom, has a substantial adverse effect on cancer patients' quality of life. Exercise is the most effective nonpharmacological intervention for managing CRF. Patients with advanced lung cancer experience CRF; this warrants carefully design of a suitable exercise program to aid these patients. This randomized controlled study determined whether an exercise program can alleviate CRF and symptom disturbance in patients with advanced lung cancer. In total, 54 patients were enrolled in this study; 17 patients were lost to follow-up due to disease progression. All enrolled patients were randomly assigned to the experimental and control groups. All 19 patients in the experimental group underwent a specially designed exercise program, and all 18 patients in the control group were asked to perform regular home activity patterns. All patients were followed for 8 weeks. The following tools of evaluation were used: Taiwanese version of the Brief Fatigue Inventory Form, Taiwanese version of the Anderson Symptom Inventory Form, and a 6-minute walk distance before and after the intervention. The results of this study revealed that the exercise program significantly alleviated symptoms that shorten patients' life expectancy clinically and increased activity endurance to the minimal clinically importance difference in patients with advanced lung cancer. The results can be used as a reference by medical teams for the clinical application of appropriate exercise programs.

並列關鍵字

lung cancer ； exercise ； cancer related fatigue ； symptoms disturbance

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