原发性肝癌患者症状自评与护士他评的一致性研究

Consistency between self-rating and others-rating of symptoms in patients with primary liver cancer

目的调查分析原发性肝癌患者症状自评与护士他评得分的一致性,探讨对肝癌患者进行症状他评的可行性。方法选取2015年1月—2016年8月收治于上海市浦东新区周浦医院肝胆科的原发性肝癌患者88例及该科室护士28名。自行设计原发性肝癌患者症状评估表,由患者自己及其责任护士对19项常见临床症状进行评估,分析患者自评得分与护士他评得分的一致性。结果患者与护士对疼痛、体温升高、疲乏、黄疸和体重减轻这5项症状的评分一致性良好(ICC> 0. 61,P <0. 05);对呕吐、皮肤瘙痒、麻木等10项症状的评分一致性较好或一般(ICC值为0. 21～0. 60,P <0. 05);而对苦恼和悲伤这2项症状的评分一致性较差(ICC≤0. 20,P <0. 05)。结论护士对原发性肝癌患者身体方面的症状评估与患者自评得分有较好的一致性,提示护士对患者身体症状的评估在一定程度上可作为患者症状管理的依据。

Objective To explore the consistency between self-rating and others-rating of symptoms in the patients with primary liver cancer.Methods From January 2015 to August 2016,88 patients with primary liver cancer and 28 nurses in Zhoupu Hospital,Pudong New Area,Shanghai were selected.A self-designed symptom assessment questionnaire was used to evaluate 19 common clinical symptoms of primary liver cancer.The consistency between self-rating and others-rating was analyzed.Results The scores of pain,elevated body temperature,fatigue,jaundice and weight loss were consistent well between patients and nurses(ICC>0.61,P<0.05).The scores of ten symptoms such as vomiting,pruritus,numbness had good or general consistency(ICC=0.21-0.60,P<0.05).But the scores of distress and sadness were poorly consistent(ICC≤0.20,P<0.05).Conclusion The consistency between self-rating and others-rating of physical symptoms of primary liver cancer is good,suggesting that nurses′evaluation of physical symptoms of patients could be used as a basis for symptom management to a certain extent.