影响胃癌化疗期间患者癌性疲乏发生的危险因素分析及自我管理模式的干预效果研究

Risk factors of cancer-related fatigue in patients with gastric cancer during chemotherapy and intervention effect of self-management mode

目的:探讨影响胃癌化疗期间患者癌性疲乏发生的危险因素,并分析自我管理模式对癌性疲乏的干预效果。方法:本研究由两部分组成。第一部分为横断面调查,收集2013年2月至2016年4月我院收治的胃癌患者为研究对象。发放问卷121份,有效回收107份(88.4%),统计分析可能影响患者癌性疲乏发生的危险因素。第二部分为前瞻性研究,选取2016年5月至2017年12月我院收治的71例胃癌患者为研究对象,将患者随机分为对照组与实验组。对照组患者接受常规化疗管理,实验组在常规化疗管理基础上接受自我管理模式。利用癌症疲乏量表(CFS)、癌症治疗功能评价量表(FACT-G)评价两种管理模式的差异。结果:单因素及多因素Logistic分析发现,文化程度、职业、家庭经济压力是影响胃癌患者化疗期间癌性疲乏发生的独立性危险因素(P<0.05)。患者CFS各维度内部之间、FACT-G各维度内部之间均呈正相关关系(r>0,P<0.05);CFS各维度与FACT-G各维度,两两之间均呈显著负相关关系(r<0,P<0.05)。组间比较:干预后,实验组CFS各维度得分均明显小于对照组(P<0.05)。组内比较:与干预前相比,实验组患者干预后CFS各维度得分均显著降低(P<0.05)。组间比较:干预后,实验组FACT-G各维度得分均明显大于对照组(P<0.05)。组内比较:与干预前相比,实验组患者干预后FACT-G各维度得分均显著升高(P<0. 05),但对照组患者仅有社会维度得分明显改善,其余指标与干预前无明显差异(P> 0. 05)。结论:多种因素参与了胃癌化疗患者癌性疲乏的发生,并导致患者生活质量下降。与常规化疗管理相比,自我管理模式能有效地缓解患者癌性疲乏,提高生活质量,有一定的临床推广价值。

Objective:To explore the risk factors of cancer-related fatigue in patients with gastric cancer during chemotherapy,and to analyze the intervention effect of self-management mode on cancer fatigue.Methods:The first part was to collect 121 cases of gastric cancer as the research object.A questionnaire survey was conducted to analyze the factors that might influence the occurrence of cancer fatigue.The second part was to select 71 patients as the research object.The control group received routine management,and the experimental group accepted the self-management mode.The difference between the two management models was compared.Results:Education level,occupation and family economic pressure were independent risk factors for cancer-related fatigue in patients with gastric cancer(P<0.05).There was a positive correlation between the internal CFS dimensions and the internal FACT-G dimensions,and there was a significant negative correlation between the dimensions of CFS and the dimensions of the FACT-G.After intervention,the scores of CFS in the experimental group were significantly lower than those in the control group(P<0.05).The scores of CFS in experimental group were significantly lower than those before intervention(P<0.05).After intervention,the scores of FACT-G in the experimental group were significantly higher than those in the control group(P<0.05).Compared with the intervention before the intervention,the scores of all the FACT-G dimensions in the experimental group were significantly higher(P<0.05),but the scores in the control group were significantly improved,and the other indexes were not significantly different from those before the intervention(P>0.05).Conclusion:Many factors are involved in the occurrence of cancer-related fatigue in gastric cancer patients undergoing chemotherapy.Compared with routine chemotherapy management mode,self-management mode can effectively relieve cancer fatigue.