居家乳腺癌化疗病人核心症状及影响因素

Core symptom and influencing factors of breast cancer patients in stay-at-home period after chemotherapy

目的:基于复杂网络分析构建乳腺癌化疗病人居家期间症状网络,明确乳腺癌化疗病人居家期间的核心症状及其影响因素,为构建精准化症状管理方案提供依据。方法:采用中文版安德森症状量表调查湖南省8所医院化疗后出院居家的478例乳腺癌病人中心性症状的发生情况。使用R语言构建症状网络并基于Spearman相关估计和Fruchterman-Reingold算法探索症状网络的强度、紧密中心性和中介中心性。采用二元Logistic回归分析其影响因素。结果:症状网络分析显示乳腺癌化疗病人居家期间的核心症状是疲乏;二元Logistic回归分析结果显示,手术史、居住地、化疗周期是乳腺癌化疗病人居家期间核心症状的影响因素。结论:疲乏是乳腺癌化疗病人居家期间的核心症状,建议医护人员加强出院前健康教育,指导病人在居家期间积极报告症状并处理,提高病人居家期间的生活质量。

Objective:To construct a symptom network based on complex network analysis for breast cancer in stay-at-home period after chemotherapy,and to identify the core symptom and the influencing factors,so as to provide a basis for constructing an accurate symptom management plan.Methods:The M.D.Anderson Symptom Inventory-Chinese version was used to investigate the occurrence of symptoms in 478 breast cancer patients who were discharged from eight hospitals in Hunan province after chemotherapy and were in stayat-home period.Symptom networks were constructed using R language and explored for strength,tight centrality and mediated centrality based on Spearman correlation and the Fruchterman-Reingold algorithm.Binary Logistic regression analysis was used to identify influencing factors.Results:Symptom network analysis revealed that the core symptom of breast cancer in stay-at-home period after chemotherapy was fatigue;binary Logistic regression analysis revealed that surgery,present residence,and chemotherapy cycle were influenting factors.Conclusion:Fatigue is the core symptom of breast cancer in stay-at-home period after chemotherapy.It is recommended that health care professionals should strengthen health education before patients are discharged from hospital,and instruct patients to report and deal with their symptoms actively to improve their quality of life in stay-at-home period.