中晚期宫颈癌同步放化疗患者症状群困扰及其与生活质量的相关性研究

Study on symptom cluster distress and its correlation with quality of life in patients with middle and advanced cervical cancer undergoing concurrent chemoradiotherapy

目的调查中晚期宫颈癌同步放化疗患者症状群困扰和生活质量现状。方法采用自制的中晚期宫颈癌同步放化疗患者症状评估量表、宫颈癌生活质量量表、一般资料调查表对203例中晚期宫颈癌同步放化疗患者进行横断面调查,分析患者症状群和生活质量的关系。结果中晚期宫颈癌同步放化疗患者受多种症状困扰,症状发生率排名前3位依次为疲乏(86.70%)、恶心(82.76%)、食欲下降(81.28%);症状严重程度前3位为食欲下降(3.67±1.26)分、恶心(3.65±1.16)分、害怕有性行为(3.50±1.35)分。心理症状群、营养症状群、躯体症状群、肠道症状群、泌尿系统症状群、性生活症状群与生理状况、社会/家庭状态、情感状态、功能状态、生活质量总分均呈负相关(P<0.05)。结论中晚期宫颈癌同步放化疗患者面临多种心理及生理症状困扰,严重影响生活质量,医务人员应加强对患者症状评估,积极采取有效措施预防或减轻症状的发生。

Objective To investigate the symptom cluster distress and status quo of the quality of life in the patients with middle and advanced cervical cancer undergoing concurrent radiochemotherapy.Methods A cross-sectional survey was conducted in 203 patients with middle and advanced cervical cancer treated with concurrent radiochemotherapy by using the self-made symptom evaluation scale, cervical cancer quality of life evaluation scale and general data questionnaire.The relationship between the symptom cluster distress and the quality of life in the patients was analyzed.Results The patients with middle and advanced cervical cancer were troubled by many symptoms.The top 3 of symptom occurrence rates were in turn fatigue(86.70%),nausea(82.76%) and loss of appetite(81.28%);the top 3 of symptom severity were loss of appetite(3.67±1.26) points, nausea(3.65±1.16) points and fear of sexual behavior(3.50±1.35) points.The psychological symptom cluster, nutritional symptom cluster, physical symptom cluster, intestinal tract symptom cluster, urinary system symptom cluster and sexual life symptom cluster were negatively correlated with the physiological status, social/family status, affective status, functional status and total score of quality of life(P<0.05).Conclusion The patients with middle and advanced cervical cancer undergoing concurrent radiochemotherapy face a variety of psychological and physiological symptoms distress, which seriously affect the quality of life.Medical staff should strengthen the evaluation on the patients’ symptoms and actively take effective measures to prevent or reduce the occurrence of symptoms.