肺癌化疗药学监护路径对肺癌患者癌因性疲乏和负性情绪的影响

Influence of pharmaceutical care pathway on cancer-related fatigue and negative emotion in patients with advanced lung cancer undergoing chemotherapy

目的探讨药学监护路径对晚期肺癌化疗患者癌因性疲乏和负性情绪的影响.方法以2017年1月至2018年6月永康市第一人民医院肿瘤科入院化疗并完成随访的全部140例晚期肺癌患者为研究对象,采用随机数字表法分为对照组和干预组.最终对照组(61例)进行常规临床路径管理,干预组(64例)常规临床路径联合药学路径管理;比较两组化疗前、化疗2及4个周期后癌因性疲乏、焦虑、抑郁评分.结果两组患者一般资料差异无统计学意义(均P>0.05).癌因性疲乏方面,化疗4个周期后,干预组情感、躯体、认知疲乏得分均低于对照组(t=2.975、1.512、2.393,均P<0.05).随着化疗周期增多,对照组各疲乏维度得分均升高(F=44.274、21.740、29.261、7.206,均P<0.05),干预组患者各疲乏维度得分差异亦有统计学意义(F=17.083、15.902、17.055、10.543,均P<0.01),其中行为、躯体疲乏维度得分均升高(P<0.01),而情感、认知疲乏维度得分降低(P<0.01).负性情绪方面,化疗2个周期时,干预组患者抑郁评分低于对照组(t=2.578,P<0.05),4个周期时,焦虑、抑郁评分均低于对照组(t=7.004、7.454,均P<0.05).随着化疗周期增多,对照组焦虑、抑郁得分升高(F=12.333、14.819,均P<0.05),而干预组得分下降(F=4.992、3.826,均P<0.05).结论临床药学监护路径有助于改善晚期肺癌化疗患者癌因性疲乏和负性情绪.

Objective To investigate the influence of pharmaceutical care pathway on cancer-related fatigue(CRF)and negative emotion in patients with advanced lung cancer undergoing chemotherapy.Methods Patients with advanced lung cancer admitted to the oncology department of Yongkang first people′s hospital from January 2017 to June 2018 for chemotherapy were randomly divided into two groups:61 cases received conventional clinical pathway management(control group),and 64 cases received conventional clinical pathway combined with pharmaceutical pathway management(intervention group).Fatigue,anxiety,depression scores were compared between the two groups before and after 2,4 cycles chemotherapy.Results There was no significant difference in baseline condition between the two groups(P>0.05).After 4 cycles of chemotherapy,emotional,physical and cognitive fatigue scores in the intervention group were lower than control group(t=2.975,1.512,2.393,P<0.05).With the increase of chemotherapy cycles,scores of fatigue dimensions in control group were increased(F=44.274,21.740,29.261,7.206,P<0.05).In the intervention group,there were statistically significant differences in scores of fatigue dimensions(F=17.083,15.902,17.055,10.543,P<0.01),among which,scores of behavioral and physical fatigue dimensions were increased(P<0.01),while scores of emotional and cognitive fatigue dimensions were decreased(P<0.01).In terms of negative emotions,depression scores in the intervention group were lower than those in control group at 2 cycles of chemotherapy(t=2.578,P<0.05),and at 4 cycles,anxiety and depression scores were lower than control group(t=7.004,7.454,P<0.05).As the chemotherapy cycle increased,anxiety and depression scores in the control group increased(F=12.333,14.819,P<0.05),while those in the intervention group decreased(F=4.992,3.826,P<0.05).Conclusion The pathway of clinical pharmaceutical care can significantly improve the CRF and negative emotions of patients with advanced lung cancer undergoing chemotherapy.