原发性脑肿瘤病人症状群现状及其影响因素

Current situation and influencing factors of symptom cluster in patients with primary brain tumor

目的:调查原发性脑肿瘤(PBT)病人的疾病症状,分析其症状群类型及影响因素。方法:选取2022年3月—11月在四川省某三级甲等综合医院就诊的PBT病人257例为研究对象,问卷调查使用一般资料调查表和中文版安德森脑肿瘤症状评估量表;症状群提取采用探索性因子分析法,然后采用多元线性回归分析法分析症状群影响因素。结果:本研究最终确定神经认知症状群、能量下降情绪症状群、胃肠道症状群、疼痛症状群、外观消除症状群5个症状群,最终累计方差贡献率为73.856%。多因素分析结果显示,职业、家庭人均年收入、医疗负担、肿瘤类型、肿瘤位置、是否合并慢性病、病程、卡氏功能状态(KPS)评分是不同症状群严重程度的影响因素(P<0.05)。结论:PBT病人症状负担较重,5个症状群中能量下降情绪症状群表现最突出。医护人员应重点关注的病人特征包括工人/个体/自由职业者、家庭人均年收入低、医疗负担重、伴有慢性病、病程长、KPS评分≤70分、胶质瘤和垂体瘤,特别是不同因素影响较大的症状群。

Objective:To investigate the symptoms of patients with primary brain tumor(PBT),and to explore the types of symptom clusters and the factors affecting them.Methods:A total of 257 PBT patients who attended a comprehensive tertiary hospital in Sichuan Province from March to November 2022 were selected for the study.The questionnaire survey was conducted by using the general information questionnaire and the Chinese version of the Anderson Brain Tumor Symptom Assessment Scale;the symptom clusters were extracted by using the exploratory factor analysis method,and the influencing factors of the symptom clusters were analyzed by using the multivariate linear regression analysis method.Results:Five symptom clusters were finally identified in this study,including neurocognitive symptom cluster,decreased energy mood symptom cluster,gastrointestinal symptom cluster,pain symptom cluster,and appearance elimination symptom cluster,and the cumulative variance contribution rate was 73.856%.The results of multifactorial analysis showed that occupation,annual per capita household income,burden of medical treatment,tumor type,tumor location,whether or not the tumor was combined with chronic diseases,disease duration,and Kasperger′s functional status(KPS)score were the factors influencing the severity of different symptom clusters(P<0.05).Conclusion:Patients with PBT have a high symptom burden,with the most prominent of the five symptom clusters being the energy-reducing mood cluster.Patient characteristics that should be emphasized by healthcare professionals include workers/individuals/freelancers,low per capita annual family income,high healthcare burden,chronic diseases,long duration of illness,KPS score≤70,colloid tumors and pituitary tumors,especially those symptom clusters that are influenced by different factors.