急性淋巴细胞白血病维持化疗阶段患儿的症状群及其前哨症状的调查

目的 探讨急性淋巴细胞白血病患儿维持化疗阶段症状群及各症状群的前哨症状。方法 采用便利抽样法,选取2020年6月—2021年8月在苏州大学附属儿童医院血液科病房收治的处于维持化疗阶段的急性淋巴细胞白血病患儿作为研究对象,采用记忆症状评估量表儿童版对其进行调查。采用探索性因子分析并结合Spearman秩相关分析确定症状群;基于Apriori算法关联分析确定各症状群的前哨症状。结果 急性淋巴细胞白血病患儿在维持化疗阶段存在5类症状群,即情绪心理症状群、胃肠道症状群、躯体症状群、神经系统症状群、自我形象受损症状群,其Cronbach α系数分别为0.943、0.906、0.874、0.891、0.900;睡眠困难、呕吐、咳嗽、头痛、脱发依次为上述症状群的前哨症状。结论 急性淋巴细胞白血病患儿在维持化疗阶段经历多种症状群困扰。症状群及其前哨症状的确定有利于简化症状的评估和管理,提高症状管理效率,减轻患儿及家庭的疾病负担。

Symptom Clusters and Sentinel Symptoms of Children with Acute Lymphoblastic Leukemia during Maintenance Chemotherapy

Objective To explore the symptom clusters and their sentinel symptoms in children with acute lymphoblastic leukemia during maintenance chemotherapy. Methods With convenience sampling, children with acute lymphoblastic leukemia who received maintenance chemotherapy in department of hematology of Children's Hospital of Soochow University from June 2020 to August 2021 were selected and assessed by Memorial Symptom Assessment Scale 10-18. The formation of symptom clusters was determined by exploratory factor analysis with Spearman rank correlation analysis, and the sentinel symptoms of clusters were determined by Apriori algorithm association analysis. Results Five symptom clusters in children with acute lymphoblastic leukemia during maintenance chemotherapy were identified, including emotional-psychological cluster, gastrointestinal cluster, somatic cluster, neurosystem cluster, and self-image disorder cluster, and the Cronbach ɑ coefficient was 0.943, 0.906, 0.874, 0.891 and 0.900, respectively; insomnia, vomiting, cough, headache, and hair loss were the sentinel symptoms of the clusters respectively. Conclusion Children with acute lymphoblastic leukemia experience a variety of symptom clusters during maintenance chemotherapy. The identification of symptom clusters and sentinel symptoms is helpful to simplify the evaluation and management of symptoms, improve the efficiency of symptom management, and reduce the disease burden of children and their families.