Effect Of Preoperative High-intensity Interval Training Combined With Team Empowerment Education On Patients With Lung Cancer

Objective:The purpose of this study is to explore the effects of preoperative high-intensity interval training(HIIT)combined with team empowerment education and HIIT for patients with lung cancer in terms of exercise capacity,dyspnea,anxiety,depression,exercise self-efficacy,self-care ability,postoperative indwelling time of thoracic drainage tube,length of stay,and exercise compliance.Methods:This study was conducted in the Department of Thoracic surgery of the first Hospital of Jilin University from January 2019 to October 2019.The patients were divided into three groups according to the time of admission:HIIT combined with team empowerment education group,HIIT group and control group.The control group received routine care.The HIIT combined with team empowerment education group received HIIT combined with team empowerment education intervention on the basis of routine care.The HIIT group received HIIT intervention on the basis of the control group.Team empowerment education is divided into five steps:expressing emotion,identifying problems,guiding patients to analyze problems,setting goals and implementation,and effect evaluation.HIIT means that the patient wears a heart rate monitor,first performs a warm-up exercise on a power bike for 10 minutes to reach70%of the maximum heart rate,and then performs high-intensity training for 1minute and rests for 1 minute.They can choose to rest or maintain a low-intensity exercise state according to their own conditions.After repeating the above cycle 10times,perform 5 minutes of relaxation exercise for a total of 35 minutes,once a day.The 6-minute walking distance,dyspnea,anxiety,depression,exercise self-efficacy and self-care ability were evaluated at admission,1 day before operation,1 day after operation and at discharge.At the end of the intervention,the exercise compliance of patients was recorded;at the time of discharge,the patient’s hospital stay and postoperative indwelling time of thoracic drainage tube were recorded.The collected data was analyzed using IBM SPSS Statistics 24.0 software,and the difference was considered statistically significant at P<0.05.If the measurement data conforms to the normal distribution and the homogeneity of variance,it was expressed as the mean±standard deviation,and the method of single factor analysis of variance was used to compare the variables between the three groups.If the measurement data does not follow the normal distribution,the median and interquartile range were used,and the nonparametric rank sum test was used to compare the variables between the three groups.Counting data was expressed in terms of frequency and percentage,and?~2 test was used to compare variables between three groups.When further comparing each other,in order to reduce the typeⅠerror,the Bonferroni method was used to correct the inspection level.When comparing the variables within the group before and after,if the data follow a normal distribution,then use paired t test for statistical analysis,if not follow the normal distribution,use a non-parametric rank sum test.The repeated measures analysis of variance method was used to analyze the outcome indexes of the three groups of patients at different time points(day of admission,1 day before surgery,1 day after surgery,and day of discharge).Results:(1)General information:There were no significant differences in age,gender,body mass index,smoking status,number of patients with chronic obstructive pulmonary disease,lung function,the stage of lung cancer,and lobar resection location in the three groups(all P>0.05).(2)Baseline data:The 6-minute walking distance,dyspnea,anxiety and depression,self-efficacy,and self-care ability measured by the three groups at admission were not statistically significant(P>0.05).(3)After the intervention,the 6-minute walking distance(P=0.004),dyspnea(P=0.013),anxiety(P<0.001),depression(P=0.002),exercise self-efficacy(P<0.001)and self-care ability(P<0.001)in the HIIT combined with team empowerment education group were better than those in the control group,and the differences between the two groups were statistically significant.On the first day after operation,the group of HIIT combined with team empowerment education was superior to the control group in 6-minute walking distance(P=0.001),dyspnea(P=0.002),anxiety(P<0.001),depression(P<0.001),exercise self-efficacy(P<0.001)and self-care ability(P<0.001),and the difference between the two groups was statistically significant.At discharge,the group of HIIT combined with team empowerment education was superior to the control group in 6-minute walking distance(P<0.001),dyspnea(P<0.001),anxiety(P<0.001),depression(P<0.001),exercise self-efficacy(P<0.001)and self-nursing ability(P<0.001),the difference was statistically significant.(4)After the preoperative intervention,compared with the control group,the HIIT group had statistically significant differences in anxiety(P=0.014),exercise self-efficacy(P<0.001),and self-care ability(P<0.001).The differences were all statistically significant,but there were no statistically significant differences in6-minute walking distance(P=1.000),dyspnea(P=0.257),depression(P=1.000).At1 day after operation,there were significant differences in anxiety(P=0.015),depression(P=0.030),exercise self-efficacy(P<0.001)and self-care ability(P<0.001)between the HIIT group and the control group,but there was no significant difference in 6-minute walking distance(P=0.073)and dyspnea(P=0.816)between the two groups.At discharge,compared with the control group,the HIIT group was superior to the control group in 6-minute walking distance(P=0.006),dyspnea(P=0.009),anxiety(P=0.001),depression(P=0.001),exercise self-efficacy(P<0.001)and self-care ability(P<0.001),the difference was statistically significant.(5)After the preoperative intervention,compared with HIIT group,there were significant differences in depression(P=0.026),exercise self-efficacy(P=0.011)and self-care ability(P<0.001)in the HIIT combined with team empowerment education group,but there were no significant differences in 6-minute walking distance(P=0.058),dyspnea(P=0.710)and anxiety(P=0.107).At 1 day after operation,compared with HIIT group,there were significant differences in exercise self-efficacy(P<0.001)and self-care ability(P<0.001)in the HIIT combined with team empowerment education group,but there was no significant difference in 6-minute walking distance(P=0.517),dyspnea(P=0.057),anxiety(P=0.144)and depression(P=0.147).Compared with HIIT group,there were significant differences in anxiety(P=0.006),exercise self-efficacy(P<0.001)and self-care ability(P<0.001)in the HIIT combined with team empowerment education group at discharge,but there were no significant differences in 6-minute walking distance(P=1.000),dyspnea(P=0.097)and depression(P=0.093).(6)The three groups of patients were not statistically significant in terms of length of stay before surgery(P=0.961),length of stay after surgery(P=0.146),total length of stay(P=0.291),and postoperative indwelling time of thoracic drainage tube(P=0.185).(7)After preoperative intervention,the compliance of the HIIT combined with team empowerment education group was significantly better than that of the HIIT group,and the difference between the two groups was statistically significant(P<0.001).Conclusion:The HIIT combined with team empowerment education can significantly improve the exercise capacity,exercise self-efficacy,self-care ability and exercise compliance with HIIT of patients with lung cancer,and reduce the degree of dyspnea,anxiety and depression of patients with lung cancer.Although the HIIT can significantly improve the exercise self-efficacy and self-care ability,and reduce the degree of anxiety and depression in lung cancer patients,the effects on exercise capacity and dyspnea need to be further explored.The effect of HIIT combined with team empowerment education on patients with lung cancer is more significant,which is better than that of HIIT group and control group.In the short time when lung cancer patients are waiting for surgery,HIIT combined with team empowerment education seems to be an effective rehabilitation method,which can improve the physical condition of lung cancer patients before operation,enhance the resistance to surgical stress,and promote the rapid recovery after operation.