帕金森病患者症状网络分析及核心症状识别

Symptom network analysis and core symptom recognition in patients with Parkinson's disease

目的探索帕金森病(Parkinson's disease,PD)患者症状群的种类并通过构建症状网络分析其核心症状。方法采用便利抽样法,应用一般资料问卷、PD患者症状经历量表,对2022年12月-2023年5月在河南省某三级甲等医院住院的285例PD患者进行问卷调查。采用探索性因子分析提取症状群,运用R语言构建网络布局描述症状间的关系,并计算中心性指标。结果在症状网络分析中,节点强度前3的症状是失眠(r_(s)=2.00)、尿频(r_(s)=1.66)和疲乏(r_(s)=1.64),桥梁强度前3的症状是失眠(r_(s)=0.19)、疼痛(r_(s)=0.18)和尿急(r_(s)=0.17)。结论PD患者会同时出现多种症状,症状之间相互联系,构成症状群,其中失眠是PD患者最核心的症状。医护人员在制定症状管理策略时,应综合考虑患者的整体症状表现,有针对性地采取综合干预措施。

Objective To explore the types of symptom clusters inpatients with Parkinson's disease(PD)and analyze the core symptoms through the construction of a symptom network.Methods Using convenience sampling,a total of 285 PD patients admitted to a tertiary hospital in Henan Province from December 2022 to May 2023,were surveyed by general information questionnaire and PD symptom experience scale.Symptom clusters wasextractedby exploratory factor analysis,and R language was employed to construct a network layout describing the relationships between symptoms,and the centralityindexwas calculated.Results In the symptom network analysis,the top 3 symptoms in terms of node strength were insomnia(r_(s)=2.00),frequent urination(r_(s)=1.66),and fatigue(r_(s)=1.64),while the top 3 symptoms in terms of bridge strength were insomnia(r_(s)=0.19),pain(r_(s)=0.18),and urgency of urination(r_(s)=0.17).Conclusion Patients with PD may experience a variety of symptoms simultaneously,with interrelated symptoms forming symptom clusters,among which insomnia is the most central symptom in PD patients.When developing symptom management strategies,healthcare providers should consider the overall symptom presentation of patients and implement targeted comprehensive intervention measures.