癌症患儿症状体验的现况调查

Symptom experience among children with cancer: a cross-sectional study

目的:评估和描述癌症患儿症状的发生率、频率、严重度和困扰度。方法:对125名4岁及以上的癌症患儿使用记忆症状量表进行自我评估或家长代评。结果:其症状发生率从1.6%(吞咽困难)到76.8%(出汗);最常发生(发生率≥40%)的症状包括:出汗、缺乏体力、没有食欲、急躁易怒、疼痛、恶心、感到紧张、体重下降、口干和咳嗽;在发生率<40%的症状中,困扰度较高(≥40%)的症状包括:小便有问题、吞咽困难、呕吐和口腔溃疡。处于治疗期的患儿其症状出现数量(11.35±4.10)多于未开始治疗或休疗的患儿(8.15±4.43),且不同治疗状态患儿的生理症状维度得分和总得分上差异有统计学意义(P<0.01)。结论:癌症患儿症状普遍存在,且极易受各种身心症状的困扰。运用多维的工具进行系统性的症状评估,可获得更多关于症状体验方面的信息,进而有利于医护人员更加有针对性地采取干预措施,以完善护理实践。

Objectives： To assess and describe the occurrence, frequency, severity, and distress of symptoms among pediatric cancer patients. Methods： The Memorial Symptom Assessment Scale （MSAS）, a 31-item patient-rated or parent-proxy rated instrument, provided multidimensional information about the symptoms experienced by children with cancer. This instrument was administered to 125 children with cancer over 4-year-old. Results： Symptom prevalence ranged from 1.6% for difficulty swallowing to 76.8% for sweating. The most common symptoms （prevalenee≥40%） were sweating, lack of energy, lack of appetite, feeling irritable, pain, nausea, feeling nervous, weight loss, dry mouth and cough. Of the symptoms with prevalence rates 〈40%, those that caused high distress in more than 40% patients were problems with urination, difficulty swallowing, mouth sores and vomiting. Patients who had recently received chemotherapy had significantly more symptoms than those who had not received chemotherapy for more than 1 week （11.35±4.10 vs. 8.15±4.43）, and they also had significant difference in physiological subscale scores and total MSAS scores （P〈0.01）. Conclusion： Pediatric cancer patients suffer from an array of symptoms. The prevalence, characteristics and distress associated with physical and psychological symptoms could be quantified in children with cancer. Using multidimensional instrument to do systematic assessment, rich information related with symptom experience could be acquired so that health care providers can conduct more typical interventions to improve clinical practices.