大肠癌幸存者体力活动相关临床实践指南推荐意见的内容分析

目的对国内外大肠癌幸存者体力活动相关临床实践指南的推荐意见进行内容分析,为临床制定规范、个性化的大肠癌幸存者体力活动指导方案提供参考依据。方法计算机检索国内外中英文数据库、指南网站及专业学会网站内与大肠癌幸存者体力活动相关的临床实践指南,检索时限为2009年1月1日—2019年7月1日。对指南中的推荐意见进行提取、翻译、归类整理后,采用内容分析法对指南中的推荐意见进行文献内容分析。结果共纳入7篇临床实践指南,共提取出26条大肠癌幸存者体力活动相关推荐意见,析出体力活动的安全性和益处,体力活动前评估,体力活动总量,体力活动方式,体力活动强度、频率及持续时间,体力活动注意事项,体力活动禁忌证,增加体力活动的策略共8项体力活动相关内容。结论涉及体力活动方式、总量、频率、强度、注意事项方面的推荐意见较多,推荐意见的提及频次与临床重要性之间存在不一致性,指南的部分推荐意见与国内实践内容一致,但内容较国内实践内容更多样化。应对国外的高质量指南进行本土化实践,挖掘适合我国大肠癌幸存者体力活动的证据。

Content analysis of clinical practice guideline recommendations related to physical activity in survivors of colorectal cancer

Objective To carry out content analysis of clinical practice guideline recommendations related to physical activity in survivors of colorectal cancer at home and abroad so as to provide a reference for formulating a standardized and personalized physical activity plan for survivors of colorectal cancer.Methods Clinical practice guidelines related to physical activity in survivors of colorectal cancer were retrieved in Chinese-English databases,guideline websites and professional society websites by computer from 1st,January 2009 to 1st,July 2019.Guideline recommendations were extracted,translated,classified and analyzed on content with the method of content analysis.Results A total of 7 clinical practice guidelines were included and 26 recommendations on physical activity of survivors of colorectal cancer were extracted.A total of 8-item content on physical activity were analyzed including the safety and benefits of physical activity,assessment before physical activity,amount of physical activity,way of physical activity,intensity,frequency and duration of physical activity,attention of physical activity,contraindications of physical activity and incremental strategy of physical activity.Conclusions There are many recommendations on the way,amount,frequency,intensity and attention of physical activity.There are inconsistencies between recommendation mentioned frequency and clinical importance,and consistencies between partial recommendations and domestic practice content,and the recom mendations are more diversified than domestic practice content.We should carry out localization for the high level of foreign guideline to explore the evidences suitable for physical activity in survivors of colorectal cancer in China.