| Objective: To construct an evidence-based practice program for exercise management of patients with breast cancer related lymphedema,so as to provide a scientific basis for exercise management of medical staff and such patients in the future.Methods:1.Qualitative research: To understand the current situation,existing problems and needs of the patients in exercise management.Objective sampling method was adopted to select patients with breast cancer related lymphedema who were treated in a third-class A hospital in Shenyang from January to March 2022 as research objects.Semistructured interview method was used to interview them.Content analysis method and Nvivo11.0 software were used to extract the subject.2.Summary of best evidence:Systematically searched domestic and foreign databases,collected clinical practice guidelines and systematic reviews related to the exercise management of patients with breast cancer related lymphedema,selected corresponding literature quality evaluation tools according to the categories of literature included,extracted relevant evidence from the included literature,and used JBI2014 evidence grading system for evidence pregrading.To summarize the best evidence for exercise management of breast cancer related lymphedema.3.Draft evidence-based practice program for exercise management of patients with breast cancer related lymphedema: Based on the best evidence summary as the framework,combined with the qualitative research results of patients with breast cancer related lymphedema,the content of the program was adjusted and expanded to construct the draft evidence-based practice program for exercise management of patients with breast cancer related lymphedema.4.Final draft of evidence-based practice program for exercise management of patients with breast cancer related lymphedema: The overall structure and expression methods of the first draft of evidence-based practice program for exercise management of patients with breast cancer related lymphedema were revised through expert meeting method and FAME structure,and finally evidence-based practice program for exercise management of patients with breast cancer related lymphedema was formed.Results:1.Qualitative research results: Through interviews with 13 patients with breast cancer related lymphedema,four themes were extracted: lack of cognition in exercise management,emotional experience in exercise management,factors affecting exercise management and exercise management needs;2.Summary results of the best evidence: Through systematic search,a total of 28 relevant literatures were included,including 1 best clinical practice,1 best practice information,7 clinical guidelines,3 expert consensus,and 16 systematic reviews.Evidence from 7 aspects was summarized and refined,respectively: exercise guarantee,exercise need to know,exercise type,exercise intensity,exercise time,exercise frequency,follow-up and health education;3.Formation of the first draft of exercise management for patients with breast cancer related lymphedema: The first draft of the program mainly covers 4 aspects,with 46 items of best evidence;4.Improvement of evidence-based practice program for exercise management of patients with breast cancer related lymphedema: A total of 10 experts in related fields were invited,including breast surgical nursing,lymphedema treatment,nursing management,sports rehabilitation,and evidence-based nursing.Three items were modified and seven items were added to the draft of the program through the expert meeting,and finally the evidence-based practice program of exercise management for patients with breast cancer related lymphedema was constructed.The content includes 4first-level items,8 second-level items and 53 third-level items,including sports guarantee,sports principle,sports program and health education.Conclusions:1.The status of exercise management in patients with breast cancer related lymphedema is not good,which is reflected in the lack of knowledge related to exercise management,few scientific information channels,more negative emotions during exercise and low exercise compliance;It is necessary to improve patients’ exercise management behavior and supervision.2.Through qualitative research,evidence synthesis and expert meeting methods,evidence-based practice program for exercise management of patients with breast cancer related lymphedema was constructed in line with clinical practice and meeting patients’ needs.This program was in line with the current situation of exercise management of patients with breast cancer related lymphedema,and was targeted,scientific,reliable and feasibility.To provide reference for the exercise management of breast cancer related lymphedema patients in the future,and promote the evidence-based process of exercise management of breast cancer related lymphedema patients. |
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