物理治療在癌症患者安寧緩和照護中的角色

Effects of Physical Therapy in Palliative Care for Cancer Patients

張詠家(Yung-Chia Chang) ； 黃勝堅(Sheng-Jean Huang) ； 曹昭懿(Jau-Yih Tsauo)

《物理治療》 34卷2期 (2009/04) Pp. 125-135

摘要

目的：了解物理治療在癌症患者的安寧緩和照護中可提供之服務及其效益。方法：自Pubmed、Cochrane library、中文電子期刊服務等三個資料庫進行搜尋，使用之關鍵字包括癌症、安寧緩和照護、物理治療、復健、運動治療、按摩、副作用等。結果：共納入18篇文獻，與物理治療相關之介入包括1.按摩介入，共納入8篇，改善部分包括：生理症狀、心理症狀、生活品質、睡眠品質、心情、抗憂鬱藥物的使用等，推薦等級B；2.運動介入，共納入5篇，改善部分包括：生活品質、健康狀況、精神層面、體能、體適能、憂鬱、焦慮、疲勞、情緒功能等，推薦等級B；3.多面向介入，共納入2篇，在生活品質各層面與生理、心理症狀皆有顯著進步，推薦等級C；4.單純合併醫療單位與社區服務，共納入1篇，在生活品質的各面向上皆無顯著差異，無法給予推薦等級；5.一般復健加上關節活動運動，共納入1篇，在生活獨立程度與疼痛程度上有顯著進步，無法給予推薦等級；6.包含復健之安寧緩和照護團隊服務，共納入1篇，對於最困擾的症狀之嚴重程度、生活品質、心情、情緒問題有顯著改善，無法給予推薦等級。結論：安寧緩和照護中癌症患者接受物理治療，對生活品質、身體症狀、心理症狀、生活獨立性等皆有正面幫助。

關鍵字

癌症 ； 安寧緩和照護 ； 物理治療

並列摘要

Purpose: To understand what physical therapy can provide in palliative care of cancer patient and its effectiveness. Method: We searched randomized controlled trials and clinical trials from Pubmed, Cochrane library and Chinese Electronic Periodical Services by keywords including 1.cancer, 2.palliative care or end of life care or hospice, 3.physical therapy or physiotherapy or rehabilitation or therapeutic exercise or massage during 1998 and 2008. Results: Eighteen articles were selected into this review. The interventions related to physical therapy (PT) were: 1. massage (including 8 articles, recommendation grade: B), which improved physical symptoms, psychological symptoms, QOL, sleep disturbance, mood, using anti-depression drug; 2. exercise (including 5 articles, recommendation grade: B), which improved QOL, health status, psychological status, emotion, physical capacity, fitness; 3. physical therapy in multidisciplinary intervention (including 2 articles, recommendation grade: C), which improved QOL, physical symptoms and psychological symptoms; 4. combination of medical care and community health care (including 1 article), which did not improve QOL; 5. PT in rehabilitation services with teaching ROM exercise (including 1 article), which improved activity of daily living and pain; 6. rehabilitation in palliative care team (including 1 article), which improved the severity of the most bother symptom, QOL, mood, emotion. Conclusion: Receiving physical therapy can improve QOL, physical symptoms, psychological symptoms, and activity of daily living of cancer patients in palliative care.

並列關鍵字

patients Cancer ； Palliative care ； Physical therapy