淋巴瘤化疗患者癌因性疲乏现状及影响因素分析

Cancer-related fatigue and influencing factors analysis in lymphoma patients receiving chemotherapy

目的癌因性疲乏(cancer-related fatigue,CRF)是患者在经历肿瘤或肿瘤治疗过程中所出现的主观感受,临床症状表现为精力疲乏,情绪低落,认知能力下降,兴趣丧失,无法从事原先可胜任的工作,且患者经过休息后得不到缓解,严重影响患者日常功能、参与社会活动、身心健康及生活质量。本研究旨在描述淋巴瘤化疗患者癌因性疲乏现状,并探讨其影响因素,为制定有效的护理干预措施提供依据。方法采用方便抽样法,选取2015年3月—2018年3月在温州医科大学附属第二医院进行化疗的淋巴瘤患者128例,采用一般资料调查表及Piper疲乏量表对患者进行测评,单因素分析部分采用方差分析以及Spearman相关分析,多因素部分采用logistic回归分析。结果 128例淋巴瘤化疗患者整体疲乏水平评分为(5.32±2.19)分,处于中度疲乏水平;其中存在癌因性疲乏的患者有103例,发生率为80.5%。情感疲乏水平得分(7.37±3.26)分,处于重度疲乏水平,感官维度得分(5.48±2.11)分,行为/严重性维度得分最低,平均为(5.12±1.97)分,认知/情绪维度得分(5.87±2.32)分。Logistic多因素分析显示,在影响淋巴瘤化疗患者疲乏水平的各因素中,性别(OR=3.225)、化疗次数(OR=2.883)、Ann Arbor分期(OR=3.003)具有统计学意义(P<0.05)。结论淋巴瘤化疗患者癌因性疲乏发生率高,处于中重度疲乏水平,应对男性患者、化疗次数>10次的患者以及Ann ArborⅢ期及Ⅳ期患者提供有针对性的护理,缓解淋巴瘤化疗患者的疲乏现状。

Objective Cancer-related Fatigue(CRF) in patients with tumors or tumor treatment process include the subjective feeling of tired, depression, cognitive decline, loss of interest, disability in the original job. These symptoms cannot be relieved after a rest, which seriously affect the daily function, social activities, physical and mental health and quality of life. The objective of this study is to describe the status of Cancer-related fatigue in lymphoma patients receiving chemotherapy, and to explore its influencing factors, so as to provide evidence for the development of effective nursing interventions. Methods A total of 128 lymphoma patients receiving chemotherapy in our hospital from March 2015 to March 2018 by convenience sampling were enrolled into this study. The patients were investigated by general data questionnaire and Piper Fatigue Scale. Variance analysis and Spearman correlation analysis were used in the univariate analysis and logistic regression analysis in the multivariate analysis. Results The score of overall fatigue in 128 research objects was 5.32±2.19, which was at a moderate level. A total of 103 patients were with cancer-related fatigue, with the incidence of 80.5%. Emotional fatigue level was(7.37±3.26) points, which was in a severe fatigue level;the sensory dimension score was(5.48±2.11) points;behavior/severity dimension scored average(5.12±1.97) points, which was the lowest;cognitive/emotional dimension score was(5.87±2.32). Logistic multivariate analysis showed that gender(OR=3.225), times of chemotherapy(OR=2.883) and Ann Arbor staging(OR=3.003) were statistically significant among all the factors that influenced the patients receiving chemotherapy(P<0.05).Conclusion The lymphoma patients receiving chemotherapy are usually with a moderate to severe level cancer-related fatigue, and the incidence is high. The targeted care is suggested to perform among the male patients and the patients with chemotherapy over 10 times or with Ann Arbor stage Ⅲ/Ⅳ to relieve the current state of fatigue.