肺癌患者术后症状量表的建立和评价

Establishment and evaluation of postoperative symptom inventory for patients with lung cancer

目的建立适用于肺癌手术后患者的症状评估量表,客观评价肺癌患者术后出现的症状种类和严重程度,为治疗提供科学证据。方法结合前期研究和文献、临床应用的肺癌症状评测工具、专家访谈,形成肺癌术后症状指标条目,采用德尔菲法进行两轮专家咨询确定最终指标并建立肺癌患者术后症状量表。结果肺癌患者术后常见症状依次是:咳嗽、疼痛、气短或呼吸困难、疲劳、头晕或头昏、恶心呕吐、皮下气肿、失眠、便秘。咨询专家积极系数和权威系数在第一轮为85.0%和0.88,第二轮为88.2%和0.87;9项症状指标的肯德尔协调系数第一轮和第二轮分别为0.47(P<0.001)和0.43(P<0.001)。结论肺癌患者术后症状量表专家认可度高,一致性好,未来需开展后续研究验证量表的适用性。

Objectives To construct a symptom assessment system suitable for surgical lung cancer patients,and to objectively evaluate the types and severity of postoperative symptoms in patients so as to provide evidence-based basis for the treatment of postoperative symptoms of lung cancer patients.Methods Postoperative symptom items of lung cancer were formed according to previous researches,literature review,the current lung cancer symptom assessment tools,and expert interviews.The Delphi method was used to conduct two rounds of expert consultation and a postoperative symptom inventory was established for lung cancer patients.Results Nine first-level symptom items were eventually formed:cough,pain,shortness of breath,fatigue,dizziness,nausea or vomiting,subcutaneous emphysema,insomnia,and constipation.The first round of active coefficient and authority coefficient of experts were 85.0%and 0.88,and the second round were 88.2%and 0.87.The Kendall coordination coefficients of the nine first-level symptom items were 0.47(P<0.001)and 0.43(P<0.001),respectively.Conclusions The evaluation system of postoperative symptom items for lung cancer patients is highly recognized by experts and has good consistency.