肺癌化疗患者症状群因子分析及管理对策研究

Research on symptom clusters analysis and management strategy for lung cancer patients with chemotherapy

目的探索肺癌化疗患者存在的症状群及其症状发生频率和严重程度,为肺癌化疗患者的临床医护工作提供有针对性的管理对策。方法采用中文版记忆症状评估量表对150名肺癌化疗患者进行问卷调查,采用主成分分析法进行探索性因子分析。结果 150名肺癌化疗患者平均年龄为(61.8±9.7)岁,男性占66.7%,文化程度主要为初中/中专及以下(85.4%)。症状中"担忧"发生率最高,"疼痛"严重程度较高。中文版记忆症状评估量表共提取5个公因子,分别为胃肠道不适症状群因子、疲乏相关症状群因子、心理不适症状群因子、病态行为症状群因子、不良反应症状群因子,公因子累计解释总变异60.47%。结论临床医护人员需重点关注患者一般特征,寻找症状根源;利用群内症状协同作用,做好症状群识别工作;发现重点症状群,提出针对性管理措施,以改善肺癌患者的生活质量。

Objective To investigate symptom of patients with lung cancer during chemotherapy and their incidence and severity level, for providing a proper management procedure for the patients. Methods A total of 150 lung cancer patients with chemotherapy were investigated by the Chinese version of the memorial symptom assessment scale （MSAS-Ch）. Principal component analysis was performed to conduct the exploratory factor analysis. Results The average age of all the patients was （61.8 ± 9. 7） years old, and 66. 7% were male. The cultural degree was mainly junior high school and under （ 85.4% ）. The highest incidence symptom of patients with chemotherapy was ＇ worrying＇ , and the ＇ pain＇ was most severe. Five common factors were extracted from the MSAS-Ch, explaining 60. 47% variance. The factors were intestinal discomfort symptom cluster, fatigue-related symptom cluster, psychology illness symptom cluster, sickness behavior symptom cluster, adverse reaction symptom cluster. Conclusions Clinical nursing staff should focus on general characteristics of patients and find out the source and key point of symptoms, utilize the synergistic effect of symptoms clusters and do well in recognition work, put forward targeted management procedures to improve life quality of lung cancer patients.