妇科化疗患者症状体验相关因素分析及对策

Influential Factors and Countermeasures of Symptom Experience of Gynecologic Patients Undergoing Chemotherapy

目的了解妇科恶性肿瘤患者在化疗期间的症状体验特点,分析其影响因素,并提出护理对策。方法采用方便抽样法(convenience sampling),于2011年10月至2012年1月在成都市某三甲医院接受化疗的110例妇科恶性肿瘤患者进行问卷调查,应用《患者一般资料调查表》(本研究自行设计)、《记忆症状评估量表》(MSAS)、《医院焦虑抑郁量表》(HADS)对其进行调查(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意)。结果妇科化疗患者的症状体验总发生率居前5位的为脱发、缺乏活力/乏力、恶心、疼痛、睡眠质量低;频繁程度居前5位依次为:睡眠质量低、缺乏活力/乏力、手脚麻木或刺痛、恶心、食欲差;严重程度居前5位依次为:脱发、睡眠质量低、缺乏活力/乏力、疼痛、恶心;对患者产生的困扰程度居前5位依次为:脱发、便秘、呕吐、睡眠质量低、皮肤改变。本组调查结果显示,患者症状的总发生率、频繁程度、严重程度及困扰程度的前5位存在不一致性,但某些症状(脱发、睡眠质量低、恶心等)的发生率、严重程度、困扰程度均较高。MSAS总分为(1.82±0.74)分,多因素研究结果显示:焦虑、化疗疗程、化疗方案是症状体验的影响因素(P<0.01)。结论妇科化疗患者症状体验感较为严重,妇科护理工作者应对其进行有效评估,针对患者症状体验的影响因素,采取相应的护理干预和健康教育消除或缓解症状体验感,提高患者的生存质量。

Objective To investigate the characteristics of symptom experience of the gynecologic cancer patients undergoing chemotherapy and its influencing factors. Methods From October 2011 to January 2012, a total of 110 gynecologic cancer patients undergoing chemotherapy were investigated with the Memorial Symptom Assessment Scale（MSAS）, Hospital Anxiety and Depression Scale（HADS）. Informed consent was obtained from all participates. Results During chemotherapy, gynecologic cancer patients experienced many symptoms including hair loss, lack of energy, nausea, pain, poor sleep, etc.. Those symptoms had higher incidence rates,occurred more frequently and seriously, and brought much more distress to gynecologic cancer patients than other symptoms.The total MSAS score was （1.82±0.74） score. And multi-factor analysis showed that the anxiety, chemotherapy course and chemotherapy regime exerted influence on the symptom experience （P0.01）. Conclusions Gynecologic cancer patients undergoing chemotherapy experienced more severe symptoms, so nurses should carry out effective evaluation according to patients′ symptom experience, and take corresponding nursing interventions and health education to eliminate or alleviate the patients′ symptoms experience, so as to improve the patients′ quality of life.