Abstract:

Objective To retrieve，evaluate and summarize the available evidence on non-pharmacological interventions for chemotherapy-related cognitive impairment among breast cancer patients. Methods We searched UpToDate，BMJ best practice，Guidelines International Network，National Institute for Health and Care Excellence，Scottish Intercollegiate Guidelines Network，Registered Nurses’ Association of Ontario，National Comprehensive Cancer Network，Cochrane Library，Joanna Briggs Institution Library，PubMed，Web of Science，CINAHL，SinoMed，CNKI and Wanfang to collect relevant literature including clinical decision support，evidence summaries，clinical practice guidelines，expert consensuses and systematic reviews published from database construction to May 14 of 2023. 2 researchers independently evaluated the quality of literature，extracted and summarized the best evidence. Results A total of 21 articles were included，including 1 clinical decision support，1 evidence summary，1 guideline and 18 systematic reviews. Finally，16 items of evidence were summarized into the following 6 categories：safety and effectiveness，self-management education，cognitive rehabilitation，physical activities，mindfulness-based interventions and multimodal intervention. Conclusion The best evidence summarized in this study is generally with high quality，which can serve as a guidance for clinical staff to provide evidence-based and effective non-pharmacological interventions to breast cancer patients with chemotherapy-related cognitive impairment. We should also take the characteristics of clinical environment and patients’ individual differences into consideration during the application of evidence.

Key words: Breast Neoplasms, Chemotherapy-Related Cognitive Impairment, Non-Pharmacological Interven-tions, Evidence Summary, Evidence-Based Nursing

摘要：

目的 检索、评价并汇总乳腺癌患者化疗相关认知障碍非药物干预的相关证据。方法 计算机检索UpToDate、BMJ最佳临床实践、国际指南协作网、英国国家卫生与临床优化研究所网站、苏格兰学院间指南网、加拿大安大略注册护士协会网站、美国国家综合癌症网络、Cochrane图书馆、澳大利亚乔安娜布里格斯研究所循证卫生保健数据库、PubMed、Web of Science、CINAHL、中国生物医学文献数据库、中国知网和万方数据平台中所有相关证据，包括临床决策、证据总结、指南、专家共识和系统评价，检索时限为建库至2023年5月14日。由2名研究者独立完成文献方法学质量评价和证据的提取与汇总。结果 纳入21篇文献，包括1篇临床决策、1篇证据总结、1篇指南和18篇系统评价。从安全有效性、自我管理教育与支持、认知康复训练、运动锻炼、正念干预和多策略干预6个领域提取了16条最佳证据。结论 该研究总结的最佳证据的质量和级别整体水平较高，对临床医护人员开展科学有效的乳腺癌患者化疗相关认知障碍的非药物管理具有指导意义，证据应用和转化时需充分考虑国内临床情境和患者的个体差异性。

关键词: 乳腺肿瘤, 化疗相关认知障碍, 非药物干预, 证据总结, 循证护理学