淋巴瘤患者化疗期间症状群与生活质量相关性的纵向研究

A longitudinal study on the correlations between symptom clusters and quality of life in patients with lymphoma during chemotherapy

目的:调查淋巴瘤患者在化疗期间不同时间点症状群与生活质量现状,并探讨症状群与生活质量相关性的动态变化。方法:采用纵向研究的方法,便利选取初次化疗的159例淋巴瘤患者作为调查对象,于化疗前、化疗第3周期后和第6周期后调查患者的症状出现情况及生活质量。结果:化疗前患者存在胃肠道症状群、心理相关症状群和淋巴瘤B症状群,化疗第3周期后和第6周期后淋巴瘤B症状群消失,增加化疗相关症状群。3个周期的生活质量中躯体功能、角色功能和认知功能比较差异有统计学意义(P<0.01)。化疗前和第6周期后各症状群与生活质量各维度得分呈负相关(P<0.05);化疗第3周期后化疗和心理相关症状群与生活质量各维度得分呈负相关(P<0.05)。结论:淋巴瘤患者化疗期间存在多个稳定症状群,且与生活质量得分呈负相关,提示临床工作者应对化疗期间的淋巴瘤患者进行症状管理,减轻症状负担,以提升其生活质量。

Objective:To investigate symptom clusters and quality of life in lymphoma patients at different time points during chemotherapy,and to explore the dynamic changes in the correlation between symptom clusters and quality of life.Methods:A total of 159 patients with lymphoma who received initial chemotherapy were selected conveniently.The symptoms and quality of life of the patients were investigated before chemotherapy(T1),after the third cycle(T2)and after the sixth cycle(T3).Results:Before chemotherapy,patients had gastrointestinal symptom clusters,psychological symptom clusters and lymphoma B symptom clusters.After the third and sixth cycles of chemotherapy,lymphoma B symptom clusters disappeared,and chemotherapy-related symptom clusters increased.Among quality of life,the physical function,role function and cognitive function of patients in 3 cycles were compared,and the differences were significantly different(P<0.01).Symptom groups were negatively correlated in each dimension of quality of life before chemotherapy and after the sixth cycle of chemotherapy(P<0.05).Chemotherapy-related symptom group and psychological symptom group were negatively correlated in all dimensions of quality of life after the third cycle of chemotherapy(P<0.05).Conclusion:There are multiple stable symptom clusters in lymphoma patients during chemotherapy,which are negatively correlated with quality of life.Clinicians should manage the symptoms of lymphoma patients during chemotherapy,reduce the burden of symptoms and improve the quality of life.