中老年肺癌患者胸部放疗期间症状群的调查及护理对策

Longitudinal study on symptom groups of middle-aged and elderly lung cancer patients during chest radiotherapy

目的纵向分析中老年肺癌患者不同时期症状群的特点,为制订针对性的症状管理措施提供依据。方法采用前瞻性研究设计,便利选取2021年4月—2022年5月湖北省某三级甲等综合医院肿瘤科的中老年肺癌患者,分别在放疗前1天、放疗前期、放疗后期、放疗结束时,使用安德森症状-修订版肺癌特异模块量表进行调查,对4个时间点症状发生率>20%的症状进行探索性因子分析,并进行统计描述。结果中老年肺癌患者放疗前1天有2个症状群,分别为感知症状群和肺癌特异症状群;放疗前期有4个症状群,分别为感知症状群、放疗症状群、肺癌特异症状群和消化道症状群;放疗后期有3个症状群,分别为放疗症状群、感知症状群和肺癌特异症状群;放疗结束时存在3个症状群,分别为放疗症状群、消化道症状群和感知症状群。结论中老年肺癌患者在放疗期稳定存在多个症状群,群内单症状发生率、严重程度及症状群呈动态变化,护理人员应针对肺癌患者不同放疗时期存在的症状群特征,制订高效、有针对性的护理措施,减轻患者的症状负担。

Objective To explore the characteristics of symptom groups in middle-aged and elderly lung cancer patients at different stages,with the aim of providing a basis for developing targeted symptom management in clinical practice.Methods A prospective study design was used to conveniently select middle-aged and elderly lung cancer patients from the oncology department of a tertiary A general hospital in Hubei Province from April 2021 to May 2022.The Chinese version of the Anderson Symptom Scale and lung cancer specific module were used to investigate the symptoms with a symptom incidence rate of≥20%at 4 time points,namely a day before,early stage,later stage and at the end of radiotherapy.Exploratory factor analysis was conducted and statistical descriptions were conducted.Results The results showed that there were 2 symptom groups in middle-aged and elderly lung cancer patients a day before radiotherapy,namely perceived symptom group and lung cancer specific symptom group.There are 4 symptom groups in the early stage of radiotherapy,namely perception symptom group,radiotherapy symptom group,specific symptom group,and digestive symptom group.There are 3 symptom groups in the later stage of radiotherapy,namely radiotherapy symptom group,perceived symptom group,and specific symptom group.At the end of radiotherapy,there are 3 symptom groups,namely radiotherapy symptom group,digestive symptom group,and perceptual symptom group.Conclusion The incidence,severity,and symptom group of symptoms in middle-aged and elderly lung cancer patients show dynamic changes during radiotherapy.We should fully consider the characteristics of symptom groups present at different time points during the patient’s radiotherapy period,and provide efficient and targeted intervention measures.