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Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors

암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰

  • Received : 2018.03.20
  • Accepted : 2018.04.18
  • Published : 2018.04.28

Abstract

The purpose of this study attempted to collect basic data for development of an integrated self-management program for cancer survivors who completed cancer treatment. Self-management programs are divided into symptom management and physical activity management. Symptom management includes fatigue, sleep disturbance, pain, depression and anxiety. PubMed, CINAHL and EMBASE were used for searching guidelines. Based on the guideline quality evaluation, the final 8 guidelines were analyzed. The structured table was used to extract the screening subjects, timing, contents, subjects for comprehensive assessment and contents, and summarized contents related to the physical activity and exercise in non-pharmacological approach. As a result, after the completion of cancer treatment, all cancer survivors should be screened regularly using reliable and validated tools. In the case of fatigue, physical activity was recommended as the primary intervention, but it was recommended for other symptoms as adjuvant therapy. Therefore, Cancer survivors should be encouraged to be active in their physical activity, and maintain the moderate intensity physical activity as long as they have no complication related to the cancer treatment. Motivation strategies for physical activity need to be developed and applied.

본 연구는 암 치료를 완료한 암생존자를 위한 통합 자기관리 어플리케이션 개발을 위한 기초자료를 수집하고자 시도되었다. 자기관리 프로그램은 증상관리와 신체활동관리로 구분되며 증상관리는 피로, 수면장애, 통증, 우울과 불안이 포함된다. 근거기반실무 가이드라인을 PubMed, CINAHL 및 EMBASE를 통해 검색하였으며 가이드라인 질 평가 후 최종 8개를 선정하여 분석하였다. 구조화된 표를 이용하여 스크리닝 대상자, 시기, 내용, 포괄적 사정대상자 및 사정내용을 추출하였고, 비약물적 중재 중 신체적 활동 및 운동 관련내용을 정리하였다. 통합한 결과, 암 치료 완료 후에도 모든 암 생존자를 대상으로 신뢰도와 타당도가 입증된 도구를 이용하여 정기적인 증상 스크리닝을 하여야 하고 중정도 이상의 증상 호소 시 전문가에 의한 포괄적인 사정을 요한다. 피로의 경우 신체적 활동이 일차적 중재법으로 권고되었으나 이 외 증상의 경우 보조요법 수준으로 효과가 있는 것으로 권고되었다. 따라서 암 생존자에게 꾸준한 신체적 활동을 격려하여야 하고 치료와 관련된 합병증이 없는 한 중강도의 신체활동을 꾸준히 유지할 수 있도록 중재하여야겠다. 이를 위해 신체적 활동에 대한 다양한 동기화 전략을 개발하고 적용해야 할 것으로 사료된다.

Keywords

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