大肠癌术后化疗患者症状群发生状况及其对患者日常活动的影响

Investigation of the influence of symptom clusters and related interference on the daily activities of colorectal cancer patients during the chemotherapy

目的 调查大肠癌术后化疗患者症状发生状况,探讨其症状群种类及其对患者日常活动的影响.方法 使用中文版安德森消化道癌症症状评估表（MDASI-GI）对112例大肠癌术后化疗患者进行问卷调查,利用探索性因子及回归分析方法探讨症状群对患者日常活动的影响.结果 大肠癌术后化疗患者发生率高的症状依次为疲乏[99.1％（111/112）]、悲伤[98.2％（110/112）]、味觉改变[97.3％（109/112）];症状严重程度依次为疲乏[92.8％（104/112）]、睡眠不安[92.0％（103/112）]和口干[89.3％（100/112）],且存在上肖化道症状群、情绪症状群、疲乏相关症状群与排泄相关症状群,这4个症状群对患者日常活动的影响差异有统计学意义（R2=0.782,F=96.071,P＜ 0.01）,均为症状困扰的有效预测因子.结论 大肠癌术后化疗患者症状发生率高、困扰程度重,多种症状群并存,对日常生活影响严重.医护人员应对患者症状及时评估并采取针对性的干预措施,以减轻患者的症状,改善生命质量.

Objective To investigate the influence of symptom incidence,severity,symptom clusters and related interference on the daily activities of colorectal cancer patients during the chemotherapy.Methods A sample of 112 colorectal cancer patients during the chemotherapy has been presented by M.D.Anderson Symptom Inventory （MDASI-GI） of Chinese Version.Exploratory factor and regression analysis are utilized to discuss influence of symptoms on the daily activities of patients.Results For patients with colorectal cancer after chemotherapy,the high incidence of symptoms are successively fatigue [99.1% （111/112）],sadness [98.2% （110/112）] and changes in taste [97.3% （109/112）].Meanwhile,the severe symptoms are successively fatigue [92.8% （104/112）],disturbed sleep [92.0% （103/112）] and dry mouth.Furthermore,four symptom clusters are identified as upper-gastrointestinal symptom cluster,emotional symptom cluster,fatigue-related symptom cluster and excretion-related symptom cluster which possess statistical significance to the daily activities of patients （R2=0.782,F=96.071,P〈0.01）.They were effective predictors factors of symptom distress.Conclusions Due to high relapse rate and severe condition,colorectal cancer patients during chemotherapy suffer from multiple symptoms which affect seriously daily activities of patients.Consequently,Medical staff should give prompt and accurate assessment,and then take specific intervening measures to alleviate the patients＇ symptom so as to improve patients＇ living conditions.