Palliative care needs and symptom burden in younger and older patients with end-stage renal disease undergoing maintenance hemodialysis:A cross-sectional study

Objectives:To investigate the current situation of palliative care needs and the symptom burden in patients with end-stage renal disease(ESRD)undergoing maintenance hemodialysis(MHD),and to explore whether there are differences between younger and older patients.Methods:This cross-sectional study was conducted in the hemodialysis centers of two tertiary hospitals from November 2021 to June 2022.Participants were selected by convenience sampling.Sociodemographics,clinical characteristics,the Palliative Care Outcome Scale(POS),the Dialysis Symptom Index(DSI),and health-related quality of life(EQ-5D-3L)were used for evaluation.Descriptive statistics,between-group comparisons,and correlation analysis were used to analyze the data.Results:A total of 236 patients were enrolled,including 118 younger and 118 older patients.The total median(P25,P75)POS score was 16.0(12.0,23.0),and the score was higher in older patients(P<0.01).The mean total number of symptoms in MHD patients was 15.04±5.06,and the overall median symptom severity score was 59.0(52.0,71.0);these scores were higher in the older group(P<0.01).The most common symptom was dry mouth(91.5%),followed by itching(83.1%),and dry skin(82.2%).Additionally,palliative care needs were significantly associated with symptom burden and health-related quality of life(HRQOL).Conclusions:The results showed that patients with ESRD undergoing MHD have a significant symptom burden and moderate palliative care needs,which are more severe in older patients.Therefore,interdisciplinary teams should be formed to actively manage patients’symptoms and meet the physical,psychological,social,and spiritual needs related to palliative care to improve patients’HRQOL.

Symptom burden in advanced breast cancer patients and its association between death anxiety and psychological distress

Objective:Recent research has documented psychological distress in advanced breast cancer(ABC)patients,but few studies have examined how death anxiety is affected by the symptom burden.Therefore,this study aims to explore the association among symptom burden,death anxiety and psychological distress(depression and anxiety)in ABC patients.Methods:This cross-sectional study used the Death and Dying Anxiety Scale(DADDS),9-item Patient Health Questionnaire(PHQ-9),General Anxiety Disorder-7(GAD-7)and MD Anderson Symptom Inventory(MDASI)to assess death anxiety,depression,anxiety,and symptom burden,respectively.Bias-corrected bootstrapping methods were used to estimate indirect effects and 95%confidence intervals.Results:Two hundred ABC patients completed the questionnaires.All of the respondents were females,with a mean age of 50±10 years.Initial correlation analyses revealed significant associations of death anxiety with depression(r=0.57,P<0.001),anxiety(r=0.60,P<0.001)and symptom burden(r=0.43,P<0.001).Moreover,depression(r=0.53,P<0.001)and anxiety(r=0.45,P<0.001)were significantly correlated with symptom burden.An analysis using Hayes’PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden,and between anxiety and symptom burden(contributions to the total effect of 0.247 and 0.469,respectively).Conclusions:This study provides insight into the relationship between death anxiety and symptom burden.The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.

Symptom burden amongst patients suffering from end-stage renal disease and receiving dialysis: A literature review

Patients suffering from end-stage renal disease and receiving dialysis experience a high symptom burden,which leads to an impaired quality of life and is associated with an increased risk of future hospitalisation and mortality.However,the symptom burden amongst patients undergoing dialysis was often underrecognised by clinical staff.In this paper,related works on symptom burden amongst patients with end-stage renal disease receiving dialysis,its concepts,assessment tools,status,and influencing factors were reviewed to draw clinical staff's attention for the relief of symptom burden amongst these patients and provide a reference for further research.

Heart failure symptom burden,dietary intake,and inflammation:An integrative review of the literature

Heart failure(HF)is characterized by high symptom burden including,but not limited to fatigue,dyspnea,and edema.Up to 21.5%of HF patients experience significant depressive symptoms,much higher than 7.1%in adults without HF.Diet,metabolites,and other inflammatory mechanisms have gained notable attention in recent studies for contributions to symptoms in HF.Symptoms for black adults(B/As)with HF are often influenced by lifestyle factors,which may influence their higher mortality rates;few studies address these factors.Distinguishing the links between key elements with diet,inflammation,and symptoms may bring clarity for new dietary strategies in HF clinical care.The purpose of this integrative review is to examine the existing literature regarding relationships among physiologic pathways in HF along with physical and emotional symptoms in the context of inflammation,dietary intake,tumor necrosis factor‑alpha(TNF‑a),a biomarker of inflammation,and trimethylamine‑N‑Oxide(TMAO).Based on available evidence,inflammation may be a key link between physical symptoms,diet,depression,TMAO,and TNF‑a in persons with HF and warrants further examination to clarify pathological links to solidify evidence for better guidance with dietary modifications.The literature reviewed in this study demonstrates that more work is needed to examine dietary planning,social support,and differences between men and women in the B/A community.Results of this literature review call attention to the essential,personalized care needs related to symptom monitoring and dietary planning which is expected to decrease symptom burden in the HF population.

Symptom experience and symptom burden of patients following first-ever stroke within 1 year： a cross-sectional study

Symptoms that are multidimensional and concurrent should be assessed from different dimensions and managed together. Few studies have evaluated concurrent and multidimensional symptoms in patients with stroke. Most studies of stroke focused on dysfunctions and complications. We hypothesize that patients with stroke have a heavy symptom burden within 1 year. This study aimed to describe multidimensional and concurrent symptoms within 1 year after stroke. This study recruited 230 patients with stroke from the Rehabilitation Department of Xuhui District Center Hospital of Shanghai and the Shanghai Sunshine Rehabilitation Center in China from March to September 2017. The patients＇ multidimensional symptom experience and symptom burden were analyzed using a self-made structured questionnaire and the influential factors for symptom burden were identified. The mean number of symptoms in patients with stroke was 11.7 ± 3.5. More than two thirds of the participants suffered from at least 10 co-occurring symptoms. Unilateral limb weakness had the highest prevalence and frequency. Participation restriction had the highest symptom dimensions of severity and distress. Lack of self-care ability（severity）, memory deterioration（frequency）, imbalance of body（distress）, moodiness（distress）, being unable to move limbs at will（distress）, shoulder pain（distress）, and slower response（frequency） were independent factors of the total symptom burden score. These findings can provide essential information for efficient symptom management of patients with stroke.

The investigation of symptoms burden and treatment status in patients with bone metastasis

Objective:This survey was a non-intervention study,which aimed to investigate symptom burden and treatment status in cancer patient with bone metastasis,and to make out whether patients received the normative treatment.Methods:We designed a questionnaire,the main items of which include patient's symptom burden,previous and ongoing treatment.We used it to investigate 120 patients from six different medical agencies.We examined the association between symptoms using Spearman's rank correlation.SPSS software was used to analyze data.Results:The data of one hundred one questionnaires were completed and fitted for analysis.The five most prevalent symptoms were fatigue(84.2%),unhappiness(83.2%),pain(77.2%),dry mouth(77.2%) and lack of appetite(73.3%).Three symptom clusters were identified.Cluster 1 included anxiety and unhappiness and accounted for 61.4% in all patients.Cluster 2 included pain,fatigue and constipation and accounted for 39.6% in all patients.Cluster 3 included nausea,vomiting,lack of appetite and accounted for 27.7% in all patients.Cronbach's alpha coefficient demonstrated high internal reliability in the clusters,with a coefficient ranging from 0.65 to 0.84.The proportion of patients receiving analgesic therapy,bisphosphates therapy,palliative chemotherapy and radiotherapy were 70.3%,63.4%,58.4% and 36.6% respectively.Pain in various degree was obviously alleviated(P < 0.01) after analgesic therapy.Among the surveyed patients,64 patients received bisphosphates therapy,while the administration of zoledronic acid accounted for the most large proportion.The average duration of bisphosphates administration was 5.79 months(SD = 7.43).Patients who received radiotherapy adopted multiple fractions treating mode.Conclusion:Symptom burden was common and severe in patients with bone metastasis,which often appeared as symptom cluster,and significantly affected their quality of life(QOL).The normative treatment should be strengthened to manage and control patients' symptoms and improve their QOL.The analgesic therapy was normative in patients with bone metastasis.Reasons impeding patients to receive bisphosphates were in varieties.More propaganda should be done to generalized bisphosphates therapy for patients with bone metastasis.

Development and predictive validity of the cirrhosis-associated ascites symptom scale: A cohort study of 103 patients

AIM To develop a scale of domains associated with the health-related quality-of-life(HRQOL) in patients with cirrhosis-related ascites.METHODS We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom(CAS) scale describing symptoms with a potential detrimental impact on health related quality of life(HRQL)(the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with(1) tense/severe;(2) moderate/mild; or(3) no ascites(controls). Patients also completed chronic liver disease questionnaire(CLDQ) and the Euro QoL 5-Dimensions 5-Level(EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations. RESULTS The final CAS scale included 14 items. The equivalent reliability was high(Chronbach's alpha 0.88). The validation cohort included 103 patients(72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls(mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites(mean = 23.8 points) as well as moderate/mild ascites(mean = 18.6 points)(P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score(rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score(0.67, P < 0.001). CONCLUSION The CAS is a valid tool, which reflects HRQOL in patients with ascites.

维持性血液透析患者症状困扰的多维同期症状网络分析

目的调查维持性血液透析(maintenance hemodialysis,MHD)患者症状困扰现况,并构建多维同期症状网络。方法采用便利抽样法选取2023年6-9月上海市和浙江省共3家医院的512例MHD患者为研究对象,采用透析患者症状负担调查表(dialysis frequency,severity,and symptom burden index,DFSSBI)对MHD患者30项症状的发生频率、严重程度和困扰程度进行调查。使用R软件qgraph包构建多维同期症状网络模型。结果发生率排名靠前的症状分别是瘙痒(64.45%)、皮肤干燥(64.06%)、口干(56.64%)、乏力(51.76%)、入睡困难(51.37%)。症状网络分析的结果显示,症状困扰总体焦虑的强度中心性(r_(S)=8.04)、紧密中心性(r_(C)=0.0078)和桥梁症状强度(r_(bs)=5.58)最大,中介中心性最大的症状是入睡困难(r_(B)=38)。在发生频率、严重程度和困扰程度3个维度,强度中心性最大的症状均是焦虑(r_(S)=7.62、7.83、8.02);紧密中心性最大的症状分别是焦虑(r_(C)=0.0073)、烦躁(r_(C)=0.0077)、焦虑(r_(C)=0.0080);中介中心性最大的症状分别是头晕(r_(B)=52)、入睡困难(r_(B)=38)、入睡困难(r_(B)=44)。结论焦虑是MHD患者的核心症状,最容易影响其他症状,且5个心理症状(担心、悲伤、烦躁、焦虑、紧张)之间的关联性最强,入睡困难则在症状网络中起到关键的桥梁作用,提示医护人员应提高对MHD患者心理症状的关注度并关注患者自我报告症状,同时在制定护理方案时应综合评估患者的整体情况。

前列腺癌根治术患者出院准备服务方案的构建与应用

目的基于循证护理理念构建前列腺癌根治术患者出院准备服务方案,并探讨其临床应用效果。方法将66例前列腺癌根治术患者按照入院时间分为对照组35例,观察组31例。对照组采用常规护理方法和随访方案;观察组基于文献检索及专家函询,构建前列腺癌根治术患者出院准备服务方案,并对患者实施该方案。结果出院时观察组出院准备度、出院指导质量评分显著高于对照组(均P<0.05);出院后1个月、3个月观察组焦虑及生活质量评分显著低于对照组(均P<0.05)。结论出院准备服务方案的实施可以提高前列腺癌根治术患者的出院准备度、出院指导质量,缓解患者焦虑情绪,提高生活质量。

食管癌患者围化疗期症状群调查

目的探索食管癌患者围化疗期间症状群构成及动态变化,为其化疗期间症状管理提供依据。方法选取2021年6月至2022年12月南通市肿瘤医院肿瘤中心治疗的食管癌化疗患者168例作为研究对象,采用基本信息调查表、安德森症状测评量表、症状补充问卷分别在首次入院(T1)、首次化疗(T2)、第2次化疗(T3)、末次化疗(T4)时进行问卷调查。提取症状群使用探索性因子分析。结果T1~T4时间节点的症状发生率>20%的数目分别为12、20、22、18个。症状发生率12.50%~94.12%。探索性因子分析结果:食管癌患者围化疗期间在T1~T4时间节点分别提取症状群个数3、5、6、6个。其中,睡眠紊乱症状群、认知相关症状群、心理神经症状群持续存在于T1~T4时间节点,疼痛症状群、消化道症状群存在于T2~T4时间节点,活动耐力症状群存在于T3~T4时间节点。结论食管癌患者化疗期间存在多种症状,T3、T4时间节点的症状群构成较为稳定。临床工作人员应关注食管癌患者化疗期间的症状群,并采取相应措施积极进行干预以缓解多种症状,进而降低症状群对患者的影响。

行为干预对晚期肺癌患者术后希望水平感受负担及睡眠质量的影响

目的 探讨基于Synder希望理论的行为干预对晚期肺癌患者术后心理行为症状的影响。方法 将78例晚期肺癌患者根据随机数字表法分为观察组和对照组,各39例,分别给予常规护理干预和常规护理联合基于Synder希望理论的行为干预,观察3个月。通过Herth希望指数(HHI)、自我感受负担量表(SPBS)和匹兹堡睡眠质量指数(PSQI),对比两组患者干预前后的希望水平、感受负担及睡眠质量情况。结果 干预后,观察组患者HHI各维度评分均较干预前升高,且高于对照组(P<0.01);观察组患者SPBS的经济、情感及身体负担各维度评分均较干预前降低,且低于对照组(P<0.01);观察组患者PSQI各维度评分均较干预前降低,且除催眠药物维度评分外,其他维度评分均低于对照组(P<0.05或0.01)。结论 基于Synder希望理论的行为干预应用于晚期肺癌术后,有助于提高患者的希望水平和睡眠质量,降低患者自我感受负担。

正念干预联合跨理论模型健康教育对糖尿病肾病血液透析患者症状负担及动静脉内瘘并发症的影响分析

目的探讨正念干预联合跨理论模型(the transtheoretical model,TTM)健康教育对糖尿病肾病血液透析患者症状负担及动静脉内瘘(arteriovenous fistula,AVF)并发症的影响。方法方便选取2022年1月—2023年8月山东省临沂市中医医院收治的者74例糖尿病肾病血液透析患为研究对象,依据不同护理方法分为两组,各37例。对照组实施常规护理,观察组在对照组基础上实施正念干预联合TTM健康教育护理,两组均干预3个月。对比两组症状负担[采用透析患者症状负担调查表评分(Dialysis Frequency Severity and Symptom Burden Index,DFSSBI)评估]、自我护理能力评分[采用血液透析患者AVF自我护理行为量表(Assessment Selfcare Behaviors Hemodialysis with Arteriovenous Fistual,ASBHD-AVF)评估]、AVF并发症发生情况。结果干预后,观察组DFSSBI中躯体症状、心理症状评分及总分均低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组ASBHD-AVF评分中症状体征管理、并发症预防及总分均高于对照组,差异有统计学意义(P均<0.05)。观察组AVF并发症发生率为10.81%(3/37),低于对照组的32.43%(10/37),差异有统计学意义(χ^(2)=4.573,P<0.05)。结论糖尿病肾病血液透析患者实施正念干预联合TTM健康教育护理,能减轻患者症状负担,提高自我管理能力,减少并发症的发生。

血液透析症状负担量表的汉化及信效度分析

目的引进血液透析症状负担量表,并检验其信效度。方法根据Brislin翻译原则对血液透析症状负担量表进行翻译、跨文化调试、预测试形成中文版,采用方便抽样法调查429例血液透析患者进行信效度检验。结果中文版血液透析症状负担量表内容效度0.871。探索性因子分析提炼出4项公因子,累计解释变异达75.21%。验证性因子分析证实模型与数据高度拟合。血液透析症状负担得分与透析症状指数的相关系数为0.553。量表的总体Cronbach'sα系数为0.907。结论中文版血液透析症状负担量表具备可靠的信度和效度,适宜作为评估血液透析患者症状负担的工具,给临床治疗效果评价提供了新方法,同时为实施针对性的症状负担和生活质量干预措施提供了理论依据。

心房颤动患者知觉压力现状及影响因素分析

目的:调查心房颤动患者知觉压力现状并分析其影响因素。方法:采用便利抽样法,应用一般资料调查表、匹兹堡睡眠质量指数、社会支持评定量表、中文版知觉压力量表对297例心房颤动患者进行调查。采用单因素、多元线性回归分析房颤患者知觉压力影响因素。结果:心房颤动患者知觉压力量表得分为(23.56±6.85)分,有26.2%的房颤患者知觉压力得分>28分。多元线性回归分析显示,年龄、平均月收入、房颤症状等级、睡眠质量是影响心房颤动患者知觉压力的因素(P<0.05)。结论:年龄>60岁,平均月收入低,房颤症状严重,睡眠质量差的心房颤动患者知觉压力较高。减轻症状负担,提高睡眠质量,有助于改善对压力事件的感知和评价,提高压力管理能力,降低压力水平。

癌症患者自我报告的症状负担及影响因素分析

目的:评估住院癌症患者的症状负担,探析癌症患者的症状负担现状及其影响因素。方法:通过方便抽样方法确定样本量,采用埃德蒙顿症状评估量表(edmonton symptom assessment scale,ESAS),于2022年10月至2023年5月对甘肃省人民医院放疗中心的343例癌症住院患者进行横断面描述性调查。结果:最终纳入统计的343例癌症患者中,60.1%(206/343)的患者身体症状负担报告为中重度,21.6%(74/343)的患者心理症状负担报告为中重度;个体症状中,最普遍的中重度症状是乏力(47.2%,162/343),最少报告的症状是呼吸困难(16.0%,55/343);多变量回归分析显示,女性更有可能出现中重度身体症状(P=0.048),呼吸系统肿瘤患者更容易出现中重度疼痛(P=0.021);中晚期肿瘤、放射治疗与中重度症状评分相关(P<0.05)。结论:目前癌症患者的症状负担较重,且身体症状较心理症状更明显,而患者年龄、家庭月收入、居住地与症状强度无关。

健康素养在慢性心力衰竭患者症状负担与疾病不确定感间的调节效应分析

目的探讨慢性心力衰竭(chronic heart failure,CHF)患者症状负担与疾病不确定感的关系,验证健康素养在症状负担与疾病不确定感之间的调节作用。方法采用便利抽样法选取2021年4月至2022年4月于温州医科大学附属第一医院住院的CHF患者234例为研究对象,应用Memorial心力衰竭症状评估量表、Mishel疾病不确定感成人量表、健康素养管理量表进行问卷调查。采用多元线性回归验证CHF患者健康素养在症状负担与疾病不确定感之间的调节效应。结果CHF患者的症状负担与疾病不确定感呈正相关(r=0.497,P<0.01),与健康素养呈负相关(r=-0.252,P<0.01),健康素养与疾病不确定感呈负相关(r=-0.593,P<0.01)。调节效应分析显示健康素养在CHF患者症状负担与疾病不确定感之间存在调节效应(β=-0.258,P<0.05)。简单斜率分析得出CHF患者健康素养水平较高时,症状负担对疾病不确定感正向预测作用较小(simpleslope=6.817,P<0.05)。结论CHF患者的症状负担可影响疾病不确定感水平,且受健康素养的调节,护理人员应该关注CHF患者的症状负担对疾病不确定感的影响,制定降低症状负担并提高健康素养的干预措施,以降低其疾病不确定感水平。

终末期肾病维持性血液透析患者症状负担的影响因素分析

目的分析终末期肾病维持性血液透析(MHD)患者症状负担的影响因素。方法回顾性分析2021年10月—2023年10月丽水市中医院收治的96例终末期肾病患者的临床资料,根据透析患者症状负担量表的评分结果,将患者分为高分组与低分组,每组48例。收集两组患者性别、年龄、文化程度、工作状态、婚姻状态、原发疾病、透析频率等基本资料,并比较两组患者的营养状况(白蛋白、血红蛋白)、肾功能[尿素氮(BUN)、血清肌酐(Scr)]。采用多因素一般Logistic回归分析筛选终末期肾病MHD患者高症状负担的影响因素,建立症状负担影响因素预测模型,绘制校准曲线和受试者工作特征(ROC)曲线评估预测模型的拟合效果。结果高分组年龄大于低分组(P<0.05),与低分组相比,高分组中家庭人均月收入低于2000元、病程长、自费、每周透析3次的患者占比更高(P<0.05)。高分组患者的白蛋白和血红蛋白水平均低于低分组(P<0.05),BUN和Scr水平均高于低分组(P<0.05)。多因素一般Logistic分析结果显示:年龄大[O^R=1.384(95%CI:1.139,1.681)]、透析频率高[O^R=68.743(95%CI:4.761,992.474)]、白蛋白水平低[O^R=1.384(95%CI:1.139,1.681)]、血红蛋白水平低[O^R=0.820(95%CI:0.707,0.951)]、BUN水平高[O^R=1.676(95%CI:1.129,2.489)]、Scr水平高[O^R=1.111(95%CI:1.034,1.194)]均是影响终末期肾病MHD患者症状负担的危险因素(P<0.05)。校准曲线平均绝对误差为0.056,表明模型的预测准确性高,预测误差小;ROC曲线表明模型预测准确性为0.989(95%CI:0.974,1.000),敏感性为93.8%(95%CI:0.828,0.987),特异性为97.9%(95%CI:0.889,0.999)。结论年龄、透析频率、营养状况、肾功能均是影响终末期肾病MHD患者症状负担情况的重要因素。

经济毒性在晚期肺癌病人症状负担与失志综合征中的中介效应

目的:探讨经济毒性在晚期肺癌病人症状负担与失志综合征中的中介作用。方法:采用便利抽样法选取2022年2月-2023年2月在郑州市某三级甲等医院住院的292例晚期肺癌病人作为研究对象,采用一般资料调查表、癌症病人报告结局的经济毒性量表、安德森症状量表、简化版失志量表进行问卷调查。应用SPSS 26.0软件及AMOS 28.0软件进行统计分析。结果:晚期肺癌病人经济毒性总分为(11.66±4.35)分,症状严重程度总分为(123.14±14.23)分,症状困扰程度总分为(37.96±6.31)分,失志综合征总分为(18.73±5.11)分;Pearson相关分析显示,经济毒性总分与症状严重程度、症状困扰程度及失志综合征得分均呈负相关(r值分别为-0.601,-0.537,-0.578,P<0.01),失志综合征得分与症状严重程度及症状困扰程度得分均呈正相关(r值分别为0.502,0.538,P<0.01)。Bootstrap法显示,经济毒性在症状负担与失志综合征间起部分中介作用,经济毒性在症状严重程度与失志综合征间的间接效应占总效应的33.15%。经济毒性在症状困扰程度与失志综合征间的间接效应占总效应的35.26%。结论:晚期肺癌病人经济毒性在症状负担与失志综合征间起部分中介作用,医护人员应为病人提供全面支持,降低其经济毒性,进而降低其失志水平。

乳腺癌术后患者症状负担与功能锻炼依从性的关系:希望水平的作用路径

背景功能锻炼依从性是影响乳腺癌患者术后康复效果的重要因素,患者的症状负担和希望水平均与功能锻炼依从性有关,但在乳腺癌术后患者群体中,关于三者之间关系的证据有限。目的探讨乳腺癌术后患者的希望水平在症状负担与功能锻炼依从性之间的作用路径,为改善乳腺癌术后患者功能锻炼依从性提供参考。方法于2023年3月26日—12月9日,连续选取四川省某三甲医院的312例乳腺癌术后患者为研究对象。采用中文版安德森症状评估量表(MDASI-C)、中文版Herth希望量表(HHS-C)、乳腺癌术后患者院外功能锻炼依从性量表进行调查。采用Pearson相关分析考查各量表评分的相关性。采用SPSS 25.0宏程序Process中的模型4分析希望水平在症状负担与功能锻炼依从性之间的作用路径。结果共308例(98.72%)乳腺癌术后患者完成有效问卷调查。乳腺癌术后患者MDASI-C评分与HHS-C评分和功能锻炼依从性评分均呈负相关(r=-0.202、-0.279,P均<0.01),HHS-C评分与功能锻炼依从性评分呈正相关(r=0.453,P<0.01)。乳腺癌术后患者的希望水平是症状负担与功能锻炼依从性之间的作用路径,效应值为-0.083(95%CI:-0.139~-0.009),占总效应的29.74%。结论乳腺癌术后患者的症状负担可以直接影响功能锻炼依从性,也可以通过希望水平间接影响功能锻炼依从性。

冠状动脉搭桥术患者围手术期症状群的研究进展

冠状动脉搭桥术是治疗冠状动脉病变的常用方法,患者在围手术期会面临多种症状困扰,严重影响其治疗依从性及远期预后。文章综述了冠状动脉搭桥术患者围手术期症状群、测评工具、影响因素及干预措施等,旨在为该类人群症状群的管理提供参考。