乳腺癌术后初期患者症状群及前哨症状的调查研究

Investigation of symptom clusters and sentinel symptoms in early postoperative breast cancer patients

目的调查乳腺癌术后初期患者症状群组成情况,并分析各症状群的前哨症状。方法采用便利抽样法选取309例乳腺癌切除术患者作为调查对象,通过中文版安德森症状评估量表进行调查。采用主成分分析和方差最大化正交旋转法分析症状群,并通过Apriori算法模型分析其关联性,明确各症状群的前哨症状。结果乳腺癌术后初期患者存在3个症状群,即神经-睡眠症状群[疲劳(乏力)-苦恼-疼痛-瞌睡-睡眠不安]、感知-知觉症状群(麻木-健忘-气短-悲伤-口干)和消化系统症状群(恶心-呕吐-食欲减退);疲劳是神经-睡眠症状群的前哨症状,麻木是感知-知觉症状群的前哨症状,恶心是消化系统症状群的前哨症状。结论乳腺癌术后初期患者出现多种症状群,且各症状群内均存在前哨症状。医护人员应基于前哨症状制订干预措施,以提高症状管理效率,减轻患者的症状困扰程度。

Objective To investigate the composition of symptom clusters in early postoperative breast cancer patients and analyze the sentinel symptoms of each cluster of symptoms.Methods A total of 309 patients who underwent mastectomy were conveniently sampled and surveyed using the Chinese version of the Anderson Symptom Inventory.Principal component analysis and varimax orthogonal rotation were employed to analyze the symptom clusters,and their associations were analyzed using the Apriori algorithm model to identify the sentinel symptoms of each cluster of symptoms.Results Three symptom clusters were identified in early postoperative breast cancer patients:neuro-sleep symptom cluster[fatigue(weakness)-distress-pain-sleepiness-restless sleep],sensory-perception symptom cluster(numbness-forgetfulness-shortness of breath-sadness-dry mouth),and digestive system symptom cluster(nausea-vomiting-loss of appetite).Fatigue was the sentinel symptom of the neuro-sleep symptom cluster,numbness was the sentinel symptom of the sensory-perception symptom cluster,and nausea was the sentinel symptom of the digestive system symptom cluster.Conclusion Early postoperative breast cancer patients experience multiple symptom clusters,with sentinel symptoms existing in each cluster.Healthcare staff should develop intervention measures based on sentinel symptoms to improve the efficiency of symptom management and reduce the degree of symptom distress for patients.