Abstract:

Objective To explore the effects of different walking exercises on cancer-related fatigue in patients with gastric cancer during chemotherapy.Methods The convenience sampling method was adopted to select 124 patients with gastric cancer chemotherapy admitted to a tertiary tumor hospital in Fujian Province from November 2018 to June 2019 as the research subjects. According to the bed management of the medical group,they were divided into a primary group,an intermediate group,an advanced group and a control group with 31 cases in each group. The primary,intermediate and advanced groups need to meet daily walking exercise requirements on the basis of routine care. Among them,the primary group is 5 000-7 499 steps/d;the intermediate group is 7 500-9 999 steps/d;the advanced group is ≥10 000 steps/d. The control group was given routine care and exercise education. The Chinese version of the Revised Piper Fatigue Scale（RPFS） was used for the assessment before the first chemo-therapy,the third,the fifth and the seventh admission to the hospital.Results Repeated measures analysis of variance showed that the RPFS scores of the primary,intermediate,and advanced groups were lower than those of the control group at different time points after the intervention,and the differences were statistically significant（P<0.05）;at the third chemotherapy,there was no statistically significant difference in RPFS scores among the primary,intermediate,and the advanced group（P>0.05）;during the 5th and 7th chemotherapy,the RPFS scores of the primary and intermediate groups were lower than those of the advanced group,and the differences were statistically significant（P<0.001）.Conclusion Walking exercise can reduce the severity of cancer-related fatigue in patients with gastric cancer during chemotherapy. During the first to third chemotherapy sessions,patients should be encouraged to walk ≥5 000 steps/d,and during the fourth to seventh chemotherapy sessions,it should be controlled at 5 000-9 999 steps/d.

Key words: Exercise Therapy, Gastric Cancer, Chemotherapy, Cancer-Related Fatigue, Repeated Measurement Analysis of Variance, Nursing Care

摘要：

目的 探讨不同步行运动量对胃癌患者化疗期间癌因性疲乏的影响。方法 采取便利抽样法,选取2018年11月—2019年6月福建省某三级甲等肿瘤专科医院收治的124例胃癌化疗患者作为研究对象,按照医疗组床位管理情况将其分为初级组、中级组、高级组和对照组,每组各31例。初级组、中级组和高级组在常规护理的基础上需要达到每日步行运动要求。其中,初级组要求5 000~7 499步/d;中级组7 500~9 999步/d;高级组≥10 000步/d。对照组给予常规护理及运动宣教。分别在首次化疗入院时、第3次、第5次和第7次化疗入院时,采用中文版Piper疲乏修订量表（the Revised Piper Fatigue Scale,RPFS）进行评估。结果 重复测量方差分析显示,干预后不同时间点初级组、中级组和高级组RPFS得分均低于对照组,差异具有统计学意义（P<0.05）;第3次化疗入院时,初级组、中级组和高级组RPFS得分比较,差异无统计学意义（P>0.05）;第5次和第7次化疗入院时,初级组、中级组RPFS得分均低于高级组,差异具有统计学意义（P<0.001）。结论 步行运动可减轻胃癌患者化疗期间癌因性疲乏的严重程度。在第1~3次化疗期间,应鼓励患者步行运动量≥5 000步/d,在第4~7次化疗期间,宜控制在5 000~9 999步/d。

关键词: 运动疗法, 胃癌, 化疗, 癌因性疲乏, 重复测量方差分析, 护理