步行運動對改善癌症患者癌因性疲憊成效之系統性文獻回顧及統合分析

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Title:	步行運動對改善癌症患者癌因性疲憊成效之系統性文獻回顧及統合分析
Other Titles:	Effect of Walking on Cancer Related Fatigue in Cancer Patients: Systematic Review and Meta Analysis
Authors:	林思源 LIN, SSU-YUAN
Contributors:	喬佳宜;李慧琦 CHIAO, CHIA-YI;LI, HUI-CHI 護理學系碩士班
Keywords:	步行運動;癌症;癌因性疲憊;系統性文獻回顧;統合分析 Walking exercise;Cancer;Cancer related fatigue;Systematic review;Meta Analysis
Date:	2023
Issue Date:	2023-11-22 02:10:37 (UTC+0)
Abstract:	背景：癌因性疲憊在癌症患者中是最常遇見及困擾的症狀之一，往往對於生活品質造成很大的衝擊。國內外有許多利用步行運動來緩解癌因性疲憊之研究，本系統性文獻回顧及統合分析期望整合文獻結果，提供臨床醫護人員照護癌症患者改善癌因性疲憊處置之參考。目的：利用系統性文獻回顧及統合分析整合以步行運動為主要介入措施，檢視對於改善癌症患者癌因性疲憊之成效。方法：本研究擬先進行系統性文獻回顧，以Walking、Cancer、Cancer related fatigue為關鍵字，搜尋Pubmed、Cochrane、MEDLINE、CINAHL、Embase、華藝線上圖館、碩博士論文網等電子資料庫，去除不符合文獻納入條件及重複之研究，經文獻評讀後，進行文獻回顧；接著將納入之文獻進行統合分析，整合並檢視癌症患者使用步行運動介入改善癌因性疲憊之成效。結果：納入文獻回顧20篇研究資料，包含1,289人(實驗組668人，對照組621人)，其中13篇進入統合分析，使用隨機效果模式，總效果量為-0.69 (95%CI=-1.22~-0.65, p =.01)，結果顯示步行運動輔以其他運動能顯著改善癌因性疲憊。異質性檢定結果呈現I2=91%，顯示研究中有高度異質性，因此進行次族群分析，步行運動在肺癌、急性骨髓性白血病、以及大腸癌患者、每次介入20分鐘或持續時間隨週數遞增、一週至少5天甚至每天、6至8週及隨治療不同週數不同、步行運動介入為主輔以其他運動，能有效改善癌因性疲憊。結論：本研究結果期望能提供癌症患者、相關家庭成員、以及醫療照護人員參考依據，鼓勵癌症患者藉由持續規律步行運動輔以其他運動以改善癌因性疲憊，進而改善其生活品質。 Background: Cancer-related fatigue is one of the most common and distressing symptoms experienced by cancer patients, which often has a huge influence on the quality of life. Many local and international research on the application of walking exercise relieve cancer-related fatigue have been published. This systematic review and meta-analysis research integrated these articles. The results of this research provide references for clinical staffs to plan effective relief strategies for cancer patients.Purpose: The purpose of this study aimed to integrate the effectiveness of walking exercise on cancer-related fatigue in patients with cancer.Methods: Through the systemic literature methods, this study used “Walking”, “Cancer” and “Cancer Related fatigue” as keywords to search English databases such as Pubmed、Cochrane、MEDLINE、CINAHL and Embase, and two Chinese databases such as Huayi Online Library and Taiwan master's thesis system resources. Irrelevant and repeated references were excluded. After quality assessment of the references, the systematic literature review was conducted. Finally, the meta-analysis was applied to examine the effectiveness of walking exercise intervention in improving cancer-related fatigue in cancer patients.Results: Twenty articles was included in the literature review, including 1,289 patients (Experimental: 668, Control: 621), 13 of which were included in the meta-analysis, using the random effect model, the total effect size was -0.69 (95%CI=-1.22~- 0.65, p =.01), the results showed that walking exercise with other kinds of exercises can significantly improve cancer-related fatigue. The heterogeneity test showed I2=91%, showing that there was a high degree of heterogeneity in the study. Therefore, a subgroup analysis was performed. Walking exercise performed in patients with lung cancer, acute myelogenous leukemia, and colorectal cancer. 20minutes intervention or incremental by weeks, at least 5 days a week or even every day, 6 to 8 weeks and different weeks depending on the treatment, walking exercise intervention combined with other exercises can effectively improve cancer-related fatigue.Conclusion: The results of this study are expected to provide references for cancer patients, their family members, and health-related care providers, as well as encourage cancer patients to improve cancer-related fatigue through continuous and regular walking with other kinds of exercises, thereby improving their quality of life.
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