癌症患者运动恐惧干预研究的范围综述

Interventions for kinesiophobia in cancer patients:a scoping review

摘要

目的 系统梳理癌症患者运动恐惧干预的研究现状,明确干预类型、对象、内容、形式、时长及评估工具,为临床实践提供参考。方法 依据Arksey和O'Malley范围综述框架,检索中国知网、中国生物医学文献服务系统、维普网、万方数据知识服务平台、PubMed、Web of Science、Embase、Cochrane Library、EBSCO academic及CINAHL,时限为建库至2026年1月15日。纳入针对≥18岁癌症患者的运动恐惧干预研究,不限场所及研究设计(随机对照试验、类实验、队列研究),排除无法获取全文、干预描述不清、非中英文及以及会议摘要、研究方案、综述等非原著研究。双人独立筛选提取,共纳入25篇文献,其中随机对照试验14篇、类实验10篇、队列研究1篇,来自中国、西班牙、土耳其、荷兰、瑞典、墨西哥6国。结果 现有干预包括运动干预、认知行为干预、健康教育、VR技术、移动应用支持及综合性方案,以运动干预和健康教育最为常用,坦帕运动恐惧量表(TSK)系列为主要评估工具。干预多集中于乳腺癌和肺癌,干预时长、强度异质性大;VR及多模式干预具有潜力但证据尚不充分;综合性干预效果优于单一模式。结论 当前干预研究在癌种覆盖范围、参数标准化、多学科整合及高质量证据方面存在明显不足。后续应针对不同癌种设计并验证结构化、多中心、大样本的随机对照试验,强化护士主导的多学科协作与远程数字化技术融合,以提升干预可推广性和患者长期康复效果。

Abstract

Objective To systematically review the current state of interventions for kinesiophobia in cancer patients,and to identify the types of interventions,target populations,content,delivery formats,duration,and assessment tools,so as to provide evidence for clinical practice. Methods Following the Arksey-O′Malley scoping review framework,we searched CNKI,SinoMed,VIP,WanFang,PubMed,Web of Science,Embase,Cochrane Library,EBSCO,and CINAHL from inception to January 15,2026.Studies involving cancer patients aged ≥18 years that evaluated any intervention targeting kinesiophobia were included,regardless of setting or design (randomized controlled trials,quasi-experimental studies,or cohort studies).Articles were excluded if they met any of the following criteria:unavailable full texts,poorly described interventions,non-English or non-Chinese publications,and non-original studies such as study protocols,conference abstracts,and reviews.Two reviewers independently screened and extracted data.Ultimately,25 studies were included:14 RCTs,10 quasi-experimental studies,and 1 cohort study,originating from six countries (China,Spain,Turkey,the Netherlands,Sweden,and Mexico). Results The identified interventions included exercise programmes,cognitive-behavioural therapy,health education,virtual reality (VR) technology,mobile application-based support,and comprehensive multi-component approaches.Exercise and health education were the most frequently used,with the Tampa Scale for Kinesiophobia (TSK) being the predominant assessment tool.Most studies focused on breast and lung cancer populations,with considerable heterogeneity in intervention duration and intensity.VR and multimodal interventions showed potential but lacked robust evidence;comprehensive programmes tended to yield superior effects compared with single-component interventions. Conclusions Current studies exhibit notable deficiencies in cancer type coverage,standardization of intervention parameters,multidisciplinary integration,and high-quality evidence.Future research should develop and validate structured,multicentre,large-sample randomised controlled trials across diverse cancer types,strengthen nurse-led multidisciplinary collaboration,and integrate tele-rehabilitation and digital technologies to improve generalizability and long-term patient outcomes.

关键词

运动恐惧症 / 肿瘤康复 / 运动干预 / 范围综述 / 护理干预

Key words

Kinesiophobia / Cancer rehabilitation / Exercise therapy / Scoping review / Nursing interventions

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基金资助

泸州市引智成果推广项目(2025WYZ001)