Patient and public version of the guideline for non-pharmacological interventions in breast cancer_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Jianyao ^1,2 , GUO Bingqian ^1,2 , ZHONG Chuhan ^1,2 , LIU Minfeng ¹ , LUO Xian ¹ , LI Wenji ¹ , TAN Miaoqin ¹ , LIU Hui ³ , XIA Xu ⁴ , SONG Yalan ⁵ , LI Xiaojin ¹ , ZHONG Dongmei ⁶ , ZHANG Lanfang ¹ , CHI Jing ^1,2 , LI Chaixiu ⁷ , YANG Hui ¹ , ZHOU Yingfeng ^8,9 , ZHOU Chunlan ¹⁰ , XU Dong ¹¹ ,  WU Yanni ¹

1. Nanfang Hospital, Southern Medical University, Guangzhou 510515, P. R. China;
2. School of Nursing, Southern Medical University, Guangzhou 510515, P. R. China;
3. School of Basic Medical Sciences, Lanzhou University, Lanzhou 730099, P. R. China;
4. Southern Medical University Library, Guangzhou 510515, P. R. China;
5. Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou 510095, P. R. China;
6. Dermatology Hospital of Southern Medical University (Guangdong Provincial Dermatology Hospital), Guangzhou 510091, P. R. China;
7. The Southwest Hospital of Army Medical University, Chongqing 400037, P. R. China;
8. School of Nursing, Fudan University, Shanghai 200032, P. R. China;
9. Fudan University Centre for Evidence-based Nursing, Shanghai 200032, P. R. China;
10. Evidence-Based Nursing Committee of Guangdong Nursing Association, Guangzhou 510515, P. R. China;
11. School of Health Management, Southern Medical University, Guangzhou 510515, P. R. China;

Corresponding?author：

WU Yanni, Email: yanniwuSMU@126.com

Keywords：

Breast cancer; Non-pharmacological interventions; Self-management; Patient version of guideline

DOI：

10.7507/1672-2531.202512083

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Objective To develop a patient version of guideline for non-pharmacological interventions in breast cancer, aiming to support patients decision-making and self-management. Methods Adhering to international guidelines and the World Health Organization's methodology for guideline development, health issues from the patient perspective were identified through sentiment dictionaries, in-depth individual interviews, and clinical surveys. Official websites of guidelines, professional association websites and comprehensive databases were systematically searched. The quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Resource utilization was assessed by integrating health economics evidence, and preliminary recommendations were formulated using an Evidence-to-Decision (EtD) framework. Subsequently, two rounds of online consensus meetings and one Delphi round were conducted to refine and finalize the recommendations, resulting in the final patient guideline. Results The patient and public version of guideline for non-pharmacological interventions in breast cancer encompassed three modules: disease knowledge, symptoms, and psychological well-being. It covered core content, including disease awareness, wound recovery, dietary nutrition, reproductive health, symptom management, and psychological adjustment. Conclusion Developed from the patient perspective and based on rigorous methodological processes, the guideline formulated evidence - based recommendations, which serve as a reference for breast cancer patients in decision-making and self-management.

Citation： TANG Jianyao, GUO Bingqian, ZHONG Chuhan, LIU Minfeng, LUO Xian, LI Wenji, TAN Miaoqin, LIU Hui, XIA Xu, SONG Yalan, LI Xiaojin, ZHONG Dongmei, ZHANG Lanfang, CHI Jing, LI Chaixiu, YANG Hui, ZHOU Yingfeng, ZHOU Chunlan, XU Dong, WU Yanni. Patient and public version of the guideline for non-pharmacological interventions in breast cancer. Chinese Journal of Evidence-Based Medicine, 2026, 26(6): 635-646. doi: 10.7507/1672-2531.202512083 Copy

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5.	Ballinger TJ, Althouse SK, Olsen TP, et al. A personalized, dynamic physical activity intervention is feasible and improves energetic capacity, energy expenditure, and quality of life in breast cancer survivors. Front Oncol, 2021, 11: 626180.
6.	Zhu XY, Li Z, Chen C, et al. Physical therapies for psychosomatic symptoms and quality of life induced by aromatase inhibitors in breast cancer patients: a systematic review and meta-analysis. Front Oncol, 2021, 11: 745280.
7.	Greenlee H, DuPont-Reyes MJ, Balneaves LG, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: Cancer J Clin, 2017, 67(3): 194-232.
8.	Runowicz CD, Leach CR, Henry NL, et al. American cancer society/American society of clinical oncology breast cancer survivorship care guideline. CA: Cancer J Clin, 2016, 66(1): 43-73.
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11.	Bu X, Jin C, Fan R, et al. Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer, 2022, 22(1): 135.
12.	陳耀龍, 荀楊芹, 李博, 等. 如何制訂患者指南. 協和醫學雜志, 2020, 11(4): 453-458.
13.	劉輝, 姚媛媛, 羅旭飛, 等. 患者與公眾指南的制訂方法: 進展與案例. 協和醫學雜志, 2023, 14(5): 1091-1095.
14.	Howard Balshem, Mark Helfanda, Holger J. Schunemann, 等. GRADE指南: Ⅲ. 證據質量分級. 中國循證醫學雜志, 2011, 11(4): 451-455.
15.	Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE evidence to decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ, 2016, 353: i2016.
16.	Gnatta JR, Kurebayashi LFS, Turrini RNT, et al. Aromatherapy and nursing: historical and theoretical conception. Revista Da Escola De Enfermagem Da U S P, 2016, 50(1): 130-136.
17.	Norman L, Cowan T, Coran T. The reflexology handbook: a complete guide. London (UK): Piatkus Books, 1989.
18.	劉輝. 患者與公眾指南在中國的現狀及制訂實踐. 蘭州: 蘭州大學, 2023.
19.	Kooijmans ECM, Hoogendijk EO, Drapa?a N, et al. Defining and categorizing nonpharmacologic interventions in the older population: a systematic review. J Am Med Dir Assoc, 2025, 26(1): 105306.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin, 2024, 74(3): 229-263.
2. Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. JNCC, 2024, 4(1): 47-53.
3. 中國政府網. 中共中央印發《“健康中國2030”規劃綱要》. 2016.
4. Invernizzi M, de Sire A, Lippi L, et al. Impact of rehabilitation on breast cancer related fatigue: a pilot study. Front Oncol, 2020, 10: 556718.
5. Ballinger TJ, Althouse SK, Olsen TP, et al. A personalized, dynamic physical activity intervention is feasible and improves energetic capacity, energy expenditure, and quality of life in breast cancer survivors. Front Oncol, 2021, 11: 626180.
6. Zhu XY, Li Z, Chen C, et al. Physical therapies for psychosomatic symptoms and quality of life induced by aromatase inhibitors in breast cancer patients: a systematic review and meta-analysis. Front Oncol, 2021, 11: 745280.
7. Greenlee H, DuPont-Reyes MJ, Balneaves LG, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: Cancer J Clin, 2017, 67(3): 194-232.
8. Runowicz CD, Leach CR, Henry NL, et al. American cancer society/American society of clinical oncology breast cancer survivorship care guideline. CA: Cancer J Clin, 2016, 66(1): 43-73.
9. Williams LA, Ginex PK, Ebanks GL, et al. ONS guidelines^TM for cancer treatment-related skin toxicity. Oncol Nurs Forum, 2020, 47(5): 539-556.
10. 國家腫瘤質控中心乳腺癌專家委員會, 北京乳腺病防治學會健康管理專業委員會. 中國乳腺癌隨診隨訪與健康管理指南(2022版). 中華腫瘤雜志, 2022, 44(1): 1-28.
11. Bu X, Jin C, Fan R, et al. Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer, 2022, 22(1): 135.
12. 陳耀龍, 荀楊芹, 李博, 等. 如何制訂患者指南. 協和醫學雜志, 2020, 11(4): 453-458.
13. 劉輝, 姚媛媛, 羅旭飛, 等. 患者與公眾指南的制訂方法: 進展與案例. 協和醫學雜志, 2023, 14(5): 1091-1095.
14. Howard Balshem, Mark Helfanda, Holger J. Schunemann, 等. GRADE指南: Ⅲ. 證據質量分級. 中國循證醫學雜志, 2011, 11(4): 451-455.
15. Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE evidence to decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ, 2016, 353: i2016.
16. Gnatta JR, Kurebayashi LFS, Turrini RNT, et al. Aromatherapy and nursing: historical and theoretical conception. Revista Da Escola De Enfermagem Da U S P, 2016, 50(1): 130-136.
17. Norman L, Cowan T, Coran T. The reflexology handbook: a complete guide. London (UK): Piatkus Books, 1989.
18. 劉輝. 患者與公眾指南在中國的現狀及制訂實踐. 蘭州: 蘭州大學, 2023.
19. Kooijmans ECM, Hoogendijk EO, Drapa?a N, et al. Defining and categorizing nonpharmacologic interventions in the older population: a systematic review. J Am Med Dir Assoc, 2025, 26(1): 105306.

Chinese Journal of Evidence-Based Medicine

Patient and public version of the guideline for non-pharmacological interventions in breast cancer

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