A TCM-based continuing nursing care plan for chemotherapy-induced cancer-related fatigue in breast cancer patients: A best practices implementation - 06/05/26

Doi : 10.1016/j.ibreh.2026.100052 
Juanya Chen, Meifen Dai , Yuzhen Liang, Jing Yang, Xiaoyun Li, Lihua Shan
 The Sixth Affiliated Hospital of South China University of Technology, Ghana 

Corresponding author.

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Highlights

This project develops a TCM-based continuing nursing care plan targeting cancer-related fatigue (CRF) in breast cancer patients undergoing chemotherapy, integrating evidence-based practice with TCM nursing techniques (e.g., Baduanjin, acupoint massage, five-tone therapy).
A total of 15 audit standards were established to systematically evaluate the implementation of the nursing plan, with three phases (baseline audit, strategy implementation, follow-up audit) conducted following the JBI Implementation Framework.
Post-implementation of two rounds of optimized interventions, the compliance rates of 11 out of 15 audit indicators exceeded 90%, and 4 core indicators (e.g., admission fatigue screening, pre-treatment health education) achieved 100% compliance.
The incidence of moderate-to-severe CRF in patients decreased significantly from 80% at baseline to 30% after the second round of interventions, with notable improvements in mild fatigue and non-fatigue proportions.
Systematic training for nursing staff (covering TCM nursing, evidence-based practice, and CRF management) achieved a 100% completion rate and 100% pass rate in assessments, effectively addressing knowledge gaps and operational deficiencies.
The plan addresses key barriers (e.g., scattered TCM evidence, low patient/family awareness) through integrated strategies, providing a standardized, operable clinical pathway for CRF management in breast cancer chemotherapy patients.

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Abstract

Objective

To implement an evidence-based transitional care program for breast cancer chemotherapy patients with cancer-related fatigue, developed based on traditional Chinese medicine principles, and to evaluate its clinical effectiveness, thereby providing high-quality nursing care guided by evidence-based practice for this patient population.

Introduction

Breast cancer is one of the most prevalent malignant tumors among women globally,and chemotherapy remains one of its primary treatment modalities. Cancer-related fatigue (CRF) is the most frequent and distressing adverse effect associated with chemotherapy,affecting up to 96.97% of breast cancer patients undergoing this treatment. The implementation of a CRF nursing plan grounded in traditional Chinese medicine principles holds substantial significance for broadening the clinical management strategies for CRF in breast cancer patients receiving chemotherapy,thereby enhancing both the quality of nursing care and the overall quality of life for these patients.

Methods

Breast cancer patients undergoing chemotherapy in the breast surgery department of a tertiary hospital were selected as participants, and an existing transitional care program for cancer-related fatigue based on traditional Chinese medicine principles was applied in clinical practice. Following the evidence-based nursing implementation process, 15 review indicators were established. Data were collected through methods such as medical record review, on-site inspections, and interviews. A total of 20 patients were included in the baseline group, the first intervention group, and the second intervention group, respectively, to track and observe the intervention effects. The chi-square test was used to compare differences in the incidence of cancer-related fatigue among patients at different time points.

Results

Following the implementation of the TCM concept-based continuity nursing program, the compliance rates in the first and second rounds of the intervention group showed significant improvement compared to the baseline group across multiple aspects, including fatigue screening (χ²=43.636, P < 0.001), symptom assessment (χ²=60.00, P < 0.001), health education (χ²=47.442, P < 0.001), and personalized fatigue management (χ²=33.600, P < 0.001). Through two rounds of evidence-based practice, the incidence of moderate to severe cancer-related fatigue decreased from 80% in the baseline group to 30% in the second-round intervention group (χ²=11.297, P < 0.005), indicating a significant improvement in the overall fatigue status of patients.

Conclusion

The application of a Traditional Chinese Medicine (TCM)-based transitional care program for cancer-related fatigue in breast cancer patients undergoing chemotherapy into evidence-based practice can significantly improve nursing compliance rates, yield positive effects in alleviating patients' cancer-related fatigue symptoms, and enhance their overall quality of life. This evidence-based practice model provides feasible experience and empirical evidence for the application of TCM principles in the nursing care of cancer patients.

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Keywords : Breast cancer chemotherapy, Cancer-related fatigue, Traditional chinese medicine concepts, Evidence-based practice, Nursing program application


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Vol 8

Article 100052- 2026 Retour au numéro
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  • Inference-based machine learning models to classify breast cancer subtypes
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  • Siva Teja Kakileti, Bharath Govindaraju, Sudhakar Sampangi, Geetha Manjunath

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