Abstract:

Objective To construct a postoperative resistance exercise program for patients with gastric cancer，and to explore its intervention effect on symptom clusters and quality of life. Methods Based on the interactive attainment theory，the resistance exercise program was constructed through literature analysis and expert meeting method，and the feasibility of the program was confirmed through pre-experiments. The patients undergoing radical gastrectomy in the Department of Gastric Surgery of a tertiary hospital in Zhejiang province were selected as the study subjects by convenience sampling method，with 36 patients from November to December 2023 as the control group and 36 patients from January to March 2024 as the experimental group，and the intervention continued for 7 days. The experimental group received a resistance exercise program on the basis of conventional rapid recovery surgical care，and the control group received routine rapid recovery surgical care. On the first day before surgery，the 3rd postoperative day，and the 7th postoperative day，the Anderson Symptom Assessment Scale-Gastrointestinal Tumor-Specific Module Scale and the Functional Assessment of Cancer Therapy-General were used for evaluation. Results During the application of the program，a case was excluded from the experimental group，and a case was excluded from the control group. Ultimately，70 patients were included. The results of generalized estimating equation showed that there was an interaction effect between the 2 groups in the surgery-related symptom cluster and the energy deficiency symptom cluster（P<0.05）. Simple effect analysis showed that on the 7th day after surgery，the scores of the surgery-related symptom cluster in the experimental group and the control group were 3（1，5） and 5（3，9） respectively，and the scores of the energy deficiency symptom cluster were 6（8，18） and 14（8，19） respectively，with statistically significant differences（P<0.05）. The quality of life scores of the experimental group and the control group were（82.06 ± 9.89） and（73.86 ± 13.08） respectively，with statistically significant differences（P=0.004）. No adverse events occurred in either group. Conclusion The resistance exercise program is scientific，safe and feasible，which can improve the surgery-related symptoms and energy deficiency symptoms，and improve the quality of life of patients with gastric cancer after surgery.

Key words: Gastric Cancer, Symptom Clusters, Resistance Exercise, Symptom Management, Quality of Life, Nursing Care

摘要：

目的 构建胃癌患者术后抗阻运动方案并探讨其应用效果，旨在为临床护理实践提供借鉴。方法 基于互动达标理论，通过文献研究、专家会议、预试验构建胃癌患者术后抗阻运动方案。采用便利抽样法，选取在浙江省某三级甲等医院胃外科拟行胃癌根治术的患者为研究对象，2024年1月—3月住院的36例患者作为试验组，2023年11月—12月住院的36例患者作为对照组。试验组在常规快速康复外科护理的基础上接受抗阻运动方案干预，对照组接受常规快速康复外科护理。术前1天、术后第3天、术后第7天，采用安德森症状评估量表-胃肠道肿瘤特异性模块、癌症治疗功能评价量表-共性模块进行评估，并统计不良事件发生率。结果 方案应用过程中，试验组、对照组各剔除1例，最终纳入70例。广义估计方程分析结果显示，两组手术相关症状群及能量缺乏症状群时间与组间存在交互效应（P<0.05）；简单效应分析显示，术后第7天，试验组、对照组的手术相关症状群得分分别为3（1,5）、5（3,9）分，能量缺乏症状群得分分别为6（8，18）、14（8，19）分，差异具有统计学意义（P<0.05）。术后第7天，试验组、对照组的生活质量得分分别为（82.06±9.89）（73.86±13.08）分，差异具有统计学意义（P=0.004）。两组均未发生不良事件。结论 该研究构建的胃癌患者术后抗阻运动方案具有科学性、安全性及可行性，可改善胃癌术后患者手术相关症状群及能量缺乏症状群，并提高其生活质量。

关键词: 胃癌, 症状群, 抗阻运动, 症状管理, 生活质量, 护理