Evidence-Based Nursing for Fatigue and Quality of Life in Lung Cancer Chemotherapy

Effects of Evidence-Based Nursing Under a Quantitative Assessment Strategy on Cancer-Related Fatigue, Self-Management Ability, and Quality of Life in Lung Cancer Patients Undergoing Chemotherapy

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.

Inclusion Criteria:

• Pathologically or radiologically confirmed lung cancer (World Health Organization [WHO] 2021 diagnostic criteria).
• Scheduled to receive first-line chemotherapy (platinum-based regimen).
• Karnofsky Performance Status (KPS) score ≥60.
• Estimated survival time >6 months (assessed by treating oncologist).
• Normal mental and cognitive function (Mini-Mental State Examination [MMSE] score ≥24).
• Voluntary participation and signed informed consent.

Exclusion Criteria:

• Concurrent severe organ dysfunction (Child-Pugh score ≥B for liver; estimated glomerular filtration rate [eGFR] <30 mL/min/1.73m² for kidney).
• Active neurological disorders (e.g., stroke, epilepsy) affecting symptom reporting.
• Acute infectious diseases (e.g., tuberculosis with sputum positivity).
• Known allergies to chemotherapy drugs (e.g., platinum agents).
• Acute illnesses requiring hospitalization (e.g., pneumonia, myocardial infarction).
• Secondary malignancies (pathologically confirmed).
• Chemotherapy contraindications (e.g., uncontrolled heart failure).
• Inability to communicate in the local language (assessed via nurse interview).
• Concurrent radiotherapy or immunotherapy.
• Participation in other interventional clinical trials within 3 months.