食管癌病人术后早期症状群与生活质量的相关性研究

Correlation between postoperative early symptom clusters and quality of life in patients with esophageal cancer

目的:探讨食管癌病人术后早期症状群与病人生活质量的相关性。方法:2020年4月-2021年1月,便利抽取镇江市某三级甲等综合医院胸外科首次行食管癌术后1~3 d病人为调查对象,采用一般资料调查表、中文版安德森消化道癌症症状评估量表(MDASI⁃GI)和癌症治疗功能评价量表(FACT⁃G)对病人进行调查;通过探索性因子分析提取食管癌术后病人的症状群;Pearson相关分析探讨症状群与生活质量各维度间的相关性。结果:食管癌病人术后1~3 d严重度评分较高的症状为吞咽困难[(5.52±1.99)分]、疼痛[(5.31±1.69)分];症状困扰程度评分最高的条目为工作(包括家务劳动)[(6.69±1.93)分];探索性因子分析提取4个症状群(疲乏相关症状群、病感症状群、胃肠道症状群及情感症状群),累计方差贡献率为54.451%;食管癌术后病人生活质量总分为(53.02±13.98)分;食管癌术后1~3 d病人症状群评分与生活质量评分呈负相关。结论:食管癌术后早期病人存在4个症状群,生活质量处于较低水平,医护人员应及时评估、识别术后病人相关症状,进行有效管理,以提高术后病人的生活质量。

Objective:To investigate the correlation between postoperative early symptom clusters and quality of life(QOL)of patients with esophageal cancer.Methods:From April 2020 to January 2021,the patients who underwent esophageal cancer for the first time at 1⁃3 d postoperative in the thoracic surgery department of a general tertiary hospital in Zhenjiang city were selected as the survey subjects.General information questionnaire,the Chinese version of MD Anderson Symptom Inventory for Gastrointestinal Cancer(MDASI⁃GI),and Functional Assessment of Cancer therapy⁃G(FACT⁃G)were used to investigate postoperative patients with esophageal cancer.Symptom clusters of postoperative patients with esophageal cancer were extracted by exploratory factor analysis.Pearson correlation analysis was used to explore the correlation between symptom clusters and various dimensions of QOL.Results:Symptoms with higher severity scores in patients with esophageal cancer were dysphagia[(5.52±1.99)points]and pain[(5.31±1.69)points].The item with the highest symptom distress score was work(including housework)[(6.69±1.93)points].The exploratory factor analysis extracted 4 symptom clusters(fatigue⁃related symptom cluster,sickness symptom cluster,gastrointestinal symptom cluster,and affective symptom group cluster),and the cumulative variance contribution rate was 54.451%.The total score of QOL of patients with esophageal cancer after surgery was(53.02±13.98)points.The score of the symptom cluster of patients with esophageal cancer after 1⁃3 d was negatively correlated with the score of QOL.Conclusions:There are four symptom clusters in patients with esophageal cancer in the early postoperative period,and the QOL is at a low level.Medical staff should timely assess and identify the symptoms of postoperative patients and carry out effective management to improve the QOL of postoperative patients.