| Objective(1) To explore the effect of pulmonary rehabilitation on quality of life in lung cancer postoperative patients during chemotherapy.(2) To explore the effect of pulmonary rehabilitation cancer-related fatigue in lung cancer postoperative patients during chemotherapy.MethodFrom July,2012to June,2013,100postoperative lung cancer patients needed chemotherapy were enrolled form the Department of lung cancer, Cancer Hospital of Tianjin Medical University. The patients were randomly divided into control group (50) and intervention group (50). Patients in the control group were treated with regular nursing care. Besides the regular nursing care, patients in the intervention group were given3month’s pulmonary rehabilitation. The quality of life and cancer related fatigue were investigated at four different times, i.e. enrolled, before the first, the second and the third chemotherapy to test the effect of pulmonary rehabilitation intervention. The survey instruments concluded lung function and excise tolerance evalution, cancer patients’quality of life questionnaire (EORTC QLQ-C30), Piper Fatigue scale (PFS).The data were analyzed by SPSS16.0. Descriptive statistics, t test, χ2test, repeated measures analysis of variance etc were used to test the differences.Result(1)There was no statistical significant differences (p>0.05) between intervention group and control group in the general demographic information, such as age, sex, educational level, marital status, family income, economic burden etc, and clinical data such as operation type, pathological stage.(2) At baseline, there was no statistical significant differences (P>0.05) in FEV1%、FVC%and VC%between two groups. After the intervention, there were statistically significant differences (P<0.05) in FVC%between two groups, and there were no statistically significant differences (P>0.05) in FEV1%and VC%between two groups. The two groups were compared using repeated measures analysis of variance. There was an interaction between intervention and the time factor of FEV1%, FVC%and VC%(P<0.05). The interactive contour map displayed that FEV1%, FVC%and VC%were significantly higher with the change of time in the intervention group than the control group.(3) At baseline, there was no statistical significant differences (P>0.05) in6MWD and Borg dyspnea scores between two groups. After the intervention, there were statistically significant differences (P<0.05) in6MWD and Borg dyspnea score between two groups. The two groups were compared using repeated measures analysis of variance. There was an interaction between intervention and the time factor of6MWD and Borg scores (P<0.05). The interactive contour map displayed that6MWD was significantly higher with the change of time in the intervention group than the control group, while the Borg score was significantly lower.(4) At baseline, there was no statistical significance differences (P>0.05) in the quality of life between two groups. After the intervention, the scores of the physical function, emontional function and overall quality of life were significantly higher in the intervention group than the control group (P<0.05); the scores of fatigue, nausea and vomiting, dyspnea, insomnia and appetite loss were significantly lower in the intervention group than the control group (P<0.05). The two groups were compared using repeated measures analysis of variance:There was an interaction between intervention and the time factor of the functional dimension scores, the scores of symptoms and the scores of overall quality of life (P<0.05). The interactive contour map displayed that the functional dimension score and overall quality of life score were significantly higher with the change of time in the intervention group than the control group, while the score of symptoms was significantly lower.(5) At baseline, there was no statistical significance differences (P>0.05) in cancer-related fatigue between two groups. After the intervention, the scores of behavior fatigue and fatigue total were lower in the intervention group than the control group (P<0.05). The two groups were compared using repeated measures analysis of variance:There was an interaction between intervention and the time factor of the cancer-related fatigue scores (P<0.05). The interactive contour map displayed that the score of cancer-related fatigue was significantly lower with the change of time in the intervention group than the control group.Conclusion(1) The pulmonary rehabilitation intervention can help patients to improve the quality of life in several respects after lung cancer postoperated chemotherapy. There were significant improvement in physical function, emontional function, overall quality of life and the scores of fatigue, nausea, dyspnea, insomnia, loss of appetite. While there were no significant effect on the role function, cognitive function, social function, the scores of constipation and diarrhea.(2) The pulmonary rehabilitation intervention can help patients to improve cancer-related fatigue in several respects after lung cancer postoperated chemotherapy. There were significant improvement in behavior fatigue and the overall fatigue.While there were no significant effect in the feeling, emontioanl and cognitive fatigue.The pulmonary rehabilitation effctively prevented the deterioration of cancer-related fatigue with chemotherapy.(3)The pulmonary rehabilitation intervention can help patients to improve pulmonary function and exercise tolerance after lung cancer postoperatived chemotherapy.(4) The pulmonary rehabilitation in lung cancer patients is still in its infancy, and there is much more development in this field in the future. |
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