This prospective randomized controlled trial investigated the effects of an evidence-based nursing intervention under a quantitative assessment strategy (EB-NQAS), utilizing the Edmonton Symptom Assessment Scale (ESAS), on cancer-related fatigue, self-management ability, and quality of life in lung cancer patients undergoing chemotherapy. Outcomes were compared to a group receiving routine nursing care.
Lung cancer patients undergoing chemotherapy frequently experience significant cancer-related fatigue (CRF) and diminished quality of life (QoL), which may not be adequately addressed by conventional nursing approaches. This study aimed to evaluate the efficacy of an evidence-based nursing intervention guided by a quantitative assessment strategy (EB-NQAS). The EB-NQAS group (n=75) received personalized care plans developed by a dedicated nursing team. These plans were based on quantitative symptom assessment using the Edmonton Symptom Assessment Scale (ESAS) and incorporated evidence-based interventions for pain management (e.g., graded approach, music therapy, opioids), fatigue (e.g., activity plans, sleep optimization), nausea/vomiting prevention (e.g., prophylactic antiemetics, ginger, dietary advice), and psychological support (e.g., cognitive-behavioral therapy). Care plans were dynamically evaluated and adjusted based on daily and weekly ESAS monitoring. The control group (n=75) received routine nursing care, including standard health education, psychological support, dietary guidance, and adverse effect management. The study compared the effects of EB-NQAS versus routine nursing on CRF, self-management ability, QoL, and adverse events over a 3-month intervention period in 150 randomized lung cancer patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
150
A multifaceted nursing program using the Edmonton Symptom Assessment Scale (ESAS) for quantitative symptom assessment to guide personalized, evidence-based care plans. Interventions included tailored strategies for pain management (graded, music therapy, heat, opioids), fatigue (supervised walking, sleep optimization), nausea/vomiting prevention (prophylactic antiemetics, ginger, dietary advice), and psychological support (cognitive-behavioral therapy). Care plans were dynamically monitored and adjusted.
Standard hospital oncology nursing care including health education, general psychological support (weekly 15-minute sessions), dietary guidance based on nutritional risk screening, and verbal instructions for managing common adverse effects.
The First Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
Change in Cancer-Related Fatigue (CRF)
Assessed using the Piper Fatigue Scale (PFS). The PFS consists of 22 items covering 4 domains (behavioral, emotional, cognitive, physical), with each item scored from 0 to 10. The total score ranges from 0 to 220, where higher scores indicate more severe fatigue.
Time frame: Baseline, 1 month, and 3 months post-intervention.
Change in Self-Management Ability
Evaluated using the Adult Health Self-Management Scale (AHSMSRS). This 38-item scale assesses 3 domains (environment, behavior, cognition), with items scored from 1 to 5. The total score ranges from 38 to 190, with higher scores indicating better self-management ability.
Time frame: Baseline, 1 month, and 3 months post-intervention.
Change in Quality of Life (QoL)
Measured using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC-QLQ-C30). This questionnaire assesses 4 functioning domains and 5 symptom domains. Scores are normalized to a 0-100 scale; higher scores represent better functioning/QoL for functioning scales and more severe symptoms for symptom scales.
Time frame: Baseline, 1 month, and 3 months post-intervention.
Incidence of Chemotherapy-Related Adverse Events
Occurrence of chemotherapy-related adverse effects, including gastrointestinal reactions (nausea/vomiting ≥CTCAE grade 2), hepatic dysfunction (AST/ALT \>2 times Upper Limit of Normal), myelosuppression (neutrophils \<1.5×10⁹/L), neurotoxicity (peripheral numbness ≥grade 2), and alopecia. Adverse events were recorded daily using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Time frame: Assessed daily during the intervention period (up to 3 months).
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