肺癌术后化疗患者症状群及前哨症状的调查

Symptom Cluster and Sentinel Symptoms in Lung Cancer Patients with Postoperative Chemotherapy

目的探讨肺癌术后化疗患者症状群,识别各症状群的前哨症状。方法采用便利抽样法,选取2019年7月—2020年10月在沈阳市某三级甲等医院肿瘤内科接受化疗的肺癌术后患者作为研究对象,采用安德森症状评估量表肺癌特异性模块对其进行调查。采用主成分分析结合最大方差正交旋转法提取症状群,基于Apriori算法关联分析结果判定症状群内前哨症状。结果肺癌术后化疗患者存在4个症状群,包括消化道症状群(恶心—呕吐—便秘—食欲下降)、呼吸道症状群(咳嗽—咳痰—气短)、情绪心理症状群(悲伤感—苦恼)和躯体症状群(疲劳—嗜睡—疼痛—麻木感);其中,恶心是消化道症状群的前哨症状,咳嗽是呼吸道症状群的前哨症状,悲伤感是情绪心理症状群的前哨症状,疲劳是躯体症状群的前哨症状。结论肺癌术后化疗患者经历较多症状,且各症状群内存在前哨症状,在临床实践中,建议医护人员将前哨症状作为症状群评估和干预的切入点,并对其进行干预。

Objective To explore the symptom cluster of lung cancer patients with postoperative chemotherapy,and to identify the sentinel symptoms of each symptom cluster.Methods With convenient sampling,lung cancer patients who received chemotherapy in oncology department of one tertiary grade-A hospital in Shenyang from July 2019 to October 2020 were selected and assessed by using lung cancer specific module in Anderson symptom Assessment Scale.By using principal component analysis combined with maximum variance orthogonal rotation method,the symptom cluster was extracted,and the sentinel symptoms in the symptom cluster were determined based on Apriori algorithm association analysis.Results There were four symptom clusters in lung cancer patients with postoperative chemotherapy,including digestive tract symptom cluster(nausea-vomiting-constipation-appetite decline),respiratory symptom cluster(cough-expectoration-short breath),emotional and psychological symptom cluster(sadness-distress)and somatic symptom cluster(fatigue-nolence-pain-numbness).Nausea,cough,sadness and fatigue were sentinel symptom of these four symptom clusters respectively.Conclusion Patients with postoperative chemotherapy for lung cancer experience many symptoms,and there are sentinel symptoms in each symptom cluster.In clinical practice,it is suggested that medical staff use sentinel symptoms as an entry point for symptom cluster evaluation and intervention.