恶性肿瘤患者化疗相关症状群的调查研究分析

The investigation and analysis of chemotherapeutic symptom clusters in cancer patients

目的统计及描述恶性肿瘤患者化疗相关症状发生率及强度,探讨其症状群的分类与组成要素。方法运用中文版安德森症状评估量表,对1011例接受化疗的恶性肿瘤患者进行调查,分析统计相关症状和症状群。结果恶性肿瘤患者化疗相关症状发生率最高依次是:胃口差、疲劳、恶心、睡眠不安、苦恼,严重程度显著的分别是:疲劳、恶心、呕吐、睡眠不安、苦恼、胃口差。Spearman相关分析显示,各症状之间相关性均有统计学意义(P<0.001),存在正相关关系,其中,恶心与呕吐,苦恼与悲伤,睡眠不安与苦恼,疲劳与睡眠不安4个症状存在高度正相关。探索性因子分析和主轴分析结果显示共有2个症状群,分为疾病心理症状群、消化道症状群,克朗巴赫系数分别为0.745、0.829。结论肿瘤患者化疗相关症状发生频率高(>59%),存在明显症状群,给患者带来较大的生活干扰,临床护士应对恶性肿瘤化疗患者发生的症状进行全面评估,探索以症状群为基础的护理干预措施,改善癌症患者的生活质量。

Objective To investigate the incidence and intensity of chemotherapy related symptoms in cancer patients,explore the classification and components of its symptom clusters.Methods The Chinese version of the M.D.Anderson Symptom Inventory(MDASI-C)assessment scale was used to investigate the 1011 cancer patients with chemotherapy,analyze the related symptom and symptom clusters.Results The top cancer patients with chemotherapy symptoms were:poor appetite,fatigue,nausea,sleep disturbed,distress,The top six-severe symptoms were:fatigue,nausea,vomiting,sleep disturbed,pain,poor appetite.The Spearman correlation analysis revealed that the positive correlation associations of all symptoms had statistical significance(P<0.001),nausea and vomiting,pain and sorrow,sleep disturbed and distress,fatigue and sleep disturbed symptoms are highly positive correlation.The exploratory factor analysis and spindle analysis revealed two major symptom clusters,including disease-psychological symptom cluster and digestive-tract symptom cluster,the Clonbach’sαcoefficients were 0.745 and 0.829 respectively.Conclusion Cancer patients with chemotherapy symptoms related to high frequency(>59%),symptom clusters interference thepatients life,clinical nurses should comprehensive assessment the cancer patients symptoms,exploring the nursing measures to improve the cancer patient's life qualityon the basis of the symptoms clusters.