数字健康技术在乳腺癌相关认知障碍患者中应用的范围综述

doi:10.3761/j.issn.0254-1769.2026.19.020

摘要/Abstract

摘要：

目的对数字健康技术在乳腺癌相关认知障碍患者中的应用进行范围综述，为开展相关研究提供参考。方法以范围综述方法学框架为指导，系统检索中英文数据库中相关文献，检索时限为2016年1月1日—2026年5月19日，对纳入文献进行数据提取和汇总分析。结果共纳入16篇文献，包括11篇随机对照试验、4篇类实验研究和1篇混合研究，数字健康技术载体包括为视频会议、移动应用程序、远程医疗平台、虚拟现实及游戏化程序；干预内容以认知训练为核心，同时结合健康教育、症状管理、监督提醒、体育锻炼或身心运动及心理社会支持；评价指标涵盖整体及特定认知功能、依从性、情绪、疲劳、睡眠质量及生活质量等。结论数字健康技术在乳腺癌相关认知障碍患者中具有一定应用潜力，未来研究应立足国内患者需求，研发适配性载体，规范干预核心要素的报告标准，同时建立标准化的认知评价体系，以提升患者的康复效果和生活质量。

关键词: 数字健康, 乳腺肿瘤, 认知障碍, 远程医疗, 范围综述, 循证护理学

Abstract:

Objective To conduct a scoping review on the application of digital health technologies in breast cancer-related cognitive impairment，so as to provide references for relevant research. Methods Guided by the scoping review methodological framework，relevant literature in Chinese and English databases was systematically searched from January 1，2016 to May 19，2026. Data extraction and synthesis were performed on the included literature. Results A total of 16 articles were included，comprising 11 randomized controlled trials，4 quasi-experimental studies，and 1 mixed-methods study. The digital health technology platforms included video conferencing，mobile applications，telemedicine platforms，virtual reality，and gamified programs. The intervention content centered on cognitive training，combined with health education，symptom management，monitoring and reminders，physical or mind-body exercise，and psychosocial support. The outcome measures covered overall and specific cognitive functions，adherence，mood，fatigue，sleep，and quality of life. Conclusion Digital health technologies demonstrate certain application potential in the management of breast cancer-related cognitive impairment. Future research should be grounded in the needs of domestic patients，develop adaptive platforms，standardize the reporting of core intervention elements，and establish standardized cognitive assessment systems，so as to improve patient rehabilitation outcomes and quality of life.

Key words: Digital Health, Breast Neoplasms, Cognitive Dysfunction, Telemedicine, Scoping Review, Evidence-Based Nursing

严慧娜, 肖爽, 邹依然, 廖莲梅. 数字健康技术在乳腺癌相关认知障碍患者中应用的范围综述[J]. 中华护理杂志, 2026, 61(19): 2731-2737.

YAN Huina, XIAO Shuang, ZOU Yiran, LIAO Lianmei. Digital health technologies in patients with cancer-related cognitive impairment of breast cancer：a scoping review[J]. Chinese Journal of Nursing, 2026, 61(19): 2731-2737.

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参考文献 32

[1]	Siegel RL, Kratzer TB, Giaquinto AN, et al. Cancer statistics,2025[J]. CA Cancer J Clin, 2025, 75(1):10-45.
[2]	Demos-Davies K, Lawrence J, Seelig D. Cancer related cognitive impairment:a downside of cancer treatment[J]. Front Oncol, 2024, 14:1387251.
[3]	Mustian KM, Lin PJ, Chakrabarti A, et al. Effects of exercise on cognitive impairment in patients receiving chemotherapy:a multicenter phase Ⅲ randomized controlled trial[J]. J Natl Compr Canc Netw, 2026, 24(3):91-99. DOI URL
[4]	姚佳盈, 赵梦琴, 朱慧, 等. 癌症相关认知障碍发生率及影响因素的系统评价[J]. 中华护理教育, 2025, 22(5):623-629.
	Yao JY, Zhao MQ, Zhu H, et al. Systematic review of preva-lence and its influencing factors in patients with cancer-related cognitive impairment[J]. Chin J Nurs Educ, 2025, 22(5):623-629.
[5]	WHO. Global strategy on digital health2020-2025[EB/OL].(2021-01-30)[2026-05-24]. https://iris.who.int/bits-tream/handle/10665/344249/9789240020924-eng.pdfsequence=1.
[6]	Liu SY, Ma JR, Sun MC, et al. Mapping the landscape of di-gital health intervention strategies:25-year synthesis[J]. J Med Internet Res, 2025, 27:e59027. DOI URL
[7]	Giustiniani A, Danesin L, Pezzetta R, et al. Use of telemedicine to improve cognitive functions and psychological well-being in patients with breast cancer:a systematic review of the current literature[J]. Cancers, 2023, 15(4):1353. DOI URL
[8]	Arksey H, O’Malley L. Scoping studies:towards a methodologi-cal framework[J]. Int J Soc Res Methodol, 2005, 8(1):19-32. DOI URL
[9]	王喜益, 叶志弘, 汤磊雯. 范围综述在护理领域的应用进展[J]. 中华护理杂志, 2019, 54(8):1259-1263. DOI URL
	Wang XY, Ye ZH, Tang LW. An integrative review of scoping review applied in nursing literature[J]. Chin J Nurs, 2019, 54(8):1259-1263.
[10]	仇如霞, 顾艳荭. 范围综述报告规范(PRISMA-ScR)的解读[J]. 中国循证医学杂志, 2022, 22(6):722-730.
	Qiu RX, Gu YH. Interpretation of the PRISMA extension for scoping review(PRISMA-ScR)[J]. Chin J Evid Based Med, 2022, 22(6):722-730.
[11]	Lockwood C, dos Santos KB, Pap R. Practical guidance for knowledge synthesis:scoping review methods[J]. Asian Nurs Res, 2019, 13(5):287-294. DOI PMID
[12]	Trinh L, Cuda N, Sabiston CM, et al. The feasibility and accep-tability of a remotely delivered,combined exercise interven-tion on cognitive function in patients with breast cancer following chemotherapy:randomized controlled trial[J]. JMIR Cancer, 2026, 12:e73393. DOI URL
[13]	Binarelli G, Joly F, Christy F, et al. Digital multimodal inter-vention for cancer-related cognitive impairment in breast-cancer patients:Cog-Stim feasibility study[J]. BMC Psychiatry, 2025, 25(1):249. DOI PMID
[14]	Kleinknecht KR, Bierend M, Keim LM, et al. Computerized cognitive training improves cognitive function in primary breast cancer survivors[J]. NPJ Breast Cancer, 2024, 10(1):85. DOI PMID
[15]	Binarelli G, Lange M, Dos Santos M, et al. Digital cognitive stimulation in elderly breast cancer patients:the Cog-Tab-Age feasibility study[J]. BMC Complementary Med Ther, 2024, 24(1):209.
[16]	杨祖云. 基于虚拟现实技术的认知康复训练模式在乳腺癌CRCI病人中的应用[J]. 全科护理, 2023, 21(31):4340-4344.
	Yang ZY. Application of cognitive rehabilitation training mode based on virtual reality technology in breast cancer patients with CRCI[J]. Chin Gen Pract Nurs, 2023, 21(31):4340-4344.
[17]	Neville AR, Bernstein LJ, Sabiston CM, et al. Feasibility of a remotely-delivered yoga intervention on cognitive function in breast cancer survivors:a mixed-methods study[J]. Front Cog-nit, 2023, 2:1286844.
[18]	González-Santos á, Lopez-Garzon M, Sánchez-Salado C, et al. A telehealth-based cognitive-adaptive training(e-OTCAT) to pre-vent cancer and chemotherapy-related cognitive impairment in women with breast cancer:protocol for a randomized control-led trial[J]. Int J Environ Res Public Health, 2022, 19(12):7147. DOI URL
[19]	Myers J, Pathak HB, He JH, et al. Combined exercise and game-based cognitive training intervention:correlative pilot study of neurotrophic and inflammatory biomarkers for women with breast cancer[J]. Cancer Nurs, 2022, 1(10):1097.
[20]	von Ah D, McDonald BC, Crouch AD, et al. Randomized dou-ble-masked controlled trial of cognitive training in breast cancer survivors:a preliminary study[J]. Support Care Cancer, 2022, 30(9):7457-7467.
[21]	杨柳, 王晓梅, 张伟, 等. 虚拟认知康复训练在乳腺癌化疗相关认知障碍患者中的应用[J]. 齐鲁护理杂志, 2021, 27(24):159-162.
	Yang L, Wang XM, Zhang W, et al. Application and effect of vir-tual cognitive rehabilitation training in breast cancer patients with cognitive impairment after chemotherapy[J]. J Qilu Nurs, 2021, 27(24):159-162.
[22]	Myers JS, Cook-Wiens G, Baynes R, et al. Emerging from the haze:a multicenter,controlled pilot study of a multidimen-sional,psychoeducation-based cognitive rehabilitation interven-tion for breast cancer survivors delivered with telehealth conferencing[J]. Arch Phys Med Rehabil, 2020, 101(6):948-959. DOI URL
[23]	Bellens A, Roelant E, Sabbe B, et al. A video-game based cog-nitive training for breast cancer survivors with cognitive impair-ment:a prospective randomized pilot trial[J]. Breast, 2020, 53:23-32. DOI PMID
[24]	陈肖敏, 金艾香, 朱慧, 等. 虚拟认知康复训练在乳腺癌化疗相关认知障碍患者中的应用[J]. 中华护理杂志, 2019, 54(5):664-668. DOI URL
	Chen XM, Jin AX, Zhu H, et al. Application and effect of virtual cognitive rehabilitation training in breast cancer patients with cognitive impairment after chemotherapy[J]. Chin J Nurs, 2019, 54(5):664-668. DOI URL
[25]	Galiano-Castillo N, Arroyo-Morales M, Lozano-Lozano M, et al. Effect of an Internet-based telehealth system on functional capacity and cognition in breast cancer survivors:a secondary analysis of a randomized controlled trial[J]. Support Care Can-cer, 2017, 25(11):3551-3559.
[26]	Ferguson RJ, Sigmon ST, Pritchard AJ, et al. A randomized trial of video conference-delivered cognitive behavioral therapy for survivors of breast cancer with self-reported cognitive dysfun-ction[J]. Cancer, 2016, 122(11):1782-1791. DOI PMID
[27]	Damholdt MF, Mehlsen M, O’Toole MS, et al. Web-based cog-nitive training for breast cancer survivors with cognitive complaints:a randomized controlled trial[J]. Psychooncology, 2016, 25(11):1293-1300. DOI PMID
[28]	Daneshgar-Pironneau S, Godard J, Porro B. Combining physical and cognitive training to address cancer-related cognitive impairment:advantages and methods[J]. Med Oncol, 2025, 43(1):36. DOI
[29]	郑霞, 周洁, 胡雅, 等. 老年肿瘤患者数字健康技术使用体验的质性研究[J]. 护理学杂志, 2023, 38(23):20-24,34.
	Zheng X, Zhou J, Hu Y, et al. Experience of using digital health technology in elderly cancer patients:a qualitative study[J]. J Nurs Sci, 2023, 38(23):20-24,34.
[30]	彭燕霞, 高云飞, 雍敬敬, 等. 社区老年人对数字健康技术焦虑的现状及护理对策分析[J]. 中华护理杂志, 2023, 58(11):1345-1351. DOI URL
	Peng YX, Gao YF, Yong JJ, et al. The current status and influencing factors of technophobia among the elderly from the perspective of digital health[J]. Chin J Nurs, 2023, 58(11):1345-1351. DOI URL
[31]	杨滕, 李雯, 卢楠, 等. 虚拟现实体感运动在老年失智症患者中应用的范围综述[J]. 中华护理杂志, 2024, 59(17):2166-2172. DOI URL
	Yang T, Li W, Lu N, et al. Virtual reality motor sensing exercise in the elderly patients with dementia:a scoping review[J]. Chin J Nurs, 2024, 59(17):2166-2172.
[32]	Zhou X, Zhang XY, Zhong TS, et al. Prevalence and associated factors of chemotherapy-related cognitive impairment in older breast cancer survivors[J]. J Adv Nurs, 2024, 80(2):484-499. DOI URL