云南宣威肺癌患者化疗期间症状群和生活质量调查

目的:探讨云南省宣威市肺癌患者化疗期间的症状群与生活质量。方法:选择该院2019年1月至2019年5月接诊的60例肺癌化疗患者进行研究,采用安德森症状评估表、生存质量评估简表对所有患者进行调查,通过因子分析提取肺癌患者化疗期间的症状群,并分析症状群对患者生活质量的影响。结果:60例肺癌患者化疗期间大多会经历四大症状群:①躯体症状群;②消化道症状群;③情绪症状群;④肺癌特异性症状群。累计方差贡献率为72.83%,疲乏的发生率高达95%,且严重度高达(6.02±1.20)分,位居所有症状的首位。4种症状群与患者生活质量均呈负相关,且相关性具有统计学意义(P<0.05)。结论:云南省宣威市肺癌化疗患者经历多种症状困扰,症状之间相互协同形成4个症状群,严重影响了患者的生活质量。临床医护人员需及时准确评估患者症状困扰,形成有效干预管理措施,以提高患者生活质量。     

肺癌患者化疗期症状群管理的难点及对策

目的通过评估肺癌患者化疗期间症状群种类,针对各症状群管理的难点,提出相应对策,以提高患者生存质量。方法采用中文版安德森症状评估表及安德森症状评估量表修订版肺癌模块量表对118例肺癌化疗患者进行调查,通过因子分析提取肺癌患者化疗期间的症状群。结果肺癌患者化疗期间大多会有四大症状群:疲乏相关症状群;肺癌特异性症状群;情绪心理症状群;消化系统症状群。结论对肺癌患者化疗期间症状群管理的难点进行分析,并提出相应对策,对改善化疗期间肺癌患者的生活质量有重要意义。     

乳腺癌患者化疗后居家期间症状群特征及影响因素研究

目的 ：调查乳腺癌患者化疗后居家期间症状群的发生情况并分析其影响因素,为护理人员开展延续护理服务提供依据。方法 ：调查于湖南省8所医院化疗后出院、处于居家期间的乳腺癌患者353例,采用安德森症状评估量表调查乳腺癌患者居家期间症状的发生情况。结果 ：乳腺癌化疗患者居家期间存在2个症状群,分别为感知-知觉症状群、消化道-睡眠症状群;多元线性回归分析结果显示,年龄、照护需求满足程度、带药出院是影响症状群的因素。结论 ：乳腺癌患者化疗后居家期间受多种症状困扰,症状之间相互影响,以症状群的形式存在。在临床护理工作中,应加强对患者居家期间症状群的管理和干预,以提升患者的自我管理能力,提高患者的生活质量。     

乳腺癌患者术后化疗期间症状群对日常生活影响的调查与分析

目的调查乳腺癌患者术后化疗期间的症状群,了解症状群对日常生活的影响。方法采用中文版安德森症状量表对65例患者进行调查,通过探索性因子分析症状群。结果乳腺癌患者术后化疗期间发生率高的症状依次是疲乏、口干、食欲下降,强度显著的依次是呕吐、疲乏、苦恼。通过探索性因子分析得出4个症状群:心理症状群、上消化道症状群、口干麻木感症状群、疲乏相关症状群。症状群对患者日常生活的影响呈现相应的正相关。结论乳腺癌患者化疗期间存在多个症状群,且影响日常生活。     

肺癌化疗患者疲乏-负性情绪-疼痛-睡眠障碍症状群及其影响因素

目的探讨肺癌化疗患者疲乏-负性情绪-疼痛-睡眠障碍症状群及其影响因素。方法 2017年9-12月,便利抽样法抽取湖南省五所三级甲等医院住院治疗的肺癌化疗患者220名为研究对象。采用一般资料调查表、数字疼痛量表、简易疲乏量表、医用焦虑抑郁量表和匹兹堡睡眠质量指数量表对其进行调查,同时收集其化疗期间血液检测结果。采用聚类分析对疲乏-负性情绪-疼痛-睡眠障碍症状群进行分组,多元线性逐步回归分析筛选其影响因素。结果通过聚类分析得出,肺癌化疗患者疲乏-负性情绪-疼痛-睡眠障碍症状群分为重度和轻度两个症状组,其中化疗周期、患病时长、白细胞、血小板和谷丙转氨酶水平是其主要影响因素(均P0.05)。结论化疗周期、患病时长、血小板、白细胞和谷丙转氨酶与症状群严重程度密切相关。医护人员对于化疗周期短、患病时间较长及白细胞、血小板和谷丙转氨酶异常的患者应加强观察,及时评估,并采取针对性的预防及症状管理措施。     

肺癌患者化疗前后症状群的调查研究

目的调查肺癌患者接受化疗前后的症状群种类及症状组成,并分析其变化,为开展肺癌化疗患者症状管理提供依据。方法采用便利抽样法,应用安德森症状评估量表中文版(the Chinese version of the MD Anderson symptom inventoryMDASI-C)、修订版肺癌特异症状模块,对102例准备接受化疗的肺癌患者进行问卷调查。结果肺癌患者在化疗前后均经历多重症状困扰,持续存在的症状为疲劳和睡眠不安。通过探索性因子分析提取症状集群,化疗前后均存在的症状群为:心理症状群、肺癌特异症状群。化疗前评估得出胃肠道症状群,化疗后出现疲乏相关症状群和化疗相关症状群。结论肺癌患者化疗前后存在多个不同的症状群,对患者造成很大困扰。护士应针对患者采取系统的症状干预策略,有效管理症状群,改善患者的生活质量。     

肺癌患者的症状群及影响因素研究

目的 调查肺癌患者疾病进展和治疗过程中的相关症状,探讨患病人群的症状群种类及其影响因素.方法 采用中文版安德森症状评估量表(Chinese version of the M.D.Anderson symptom inventory,MDASI-C)、修订版肺癌症状模块对住院肺癌患者进行调查.结果 2012年8～12月共180例患者完成调查,结果显示肺癌患者普遍存在多种症状,其中以睡眠不安、疲乏、食欲下降、疼痛、气短和胸闷最为严重.探索性因子分析得出4个症状群,分别为疾病行为症状群、肺癌特异性症状群、上消化道症状群、呼吸系统症状群.多元直线回归显示功能状态、伴随疾病数量和正在接受的治疗是症状群严重程度的影响因素.结论 肺癌患者存在多种症状群,从症状群角度对患者进行症状管理,能够产生更好的临床效果,从而提高患者的生存质量.     

肺癌患者化疗期间的症状体验及相关因素研究

目的描述肺癌患者化疗期间的症状体验特点,探讨其影响因素.方法运用安德森症状评估量表,便利抽取西安市3家三级甲等医院的123例肺癌化疗患者,调查分析其化疗期间的症状体验及相关因素.结果本组的主要症状依次为:疲乏(6.26±1.62)分、苦恼(4.25±1.88)分、胃口差(4.96±2.07)分、睡眠不安(4.48±2.01)分,发生率均在90%以上;给患者的工作、一般活动、生活乐趣带来较大的困扰,其得分分别是(7.03±1.85)分、(5.42±1.69)分、(4.64±1.60)分.症状体验受在职与否、家庭人均月收入、性别、疾病临床分期4个因素的影响(P<0.05).结论肺癌患者化疗期间症状发生频率均高于50%,处于轻中度水平,受疾病的临床分期、性别等的影响,给患者带来较大的症状困扰.提示临床护士应对肺癌化疗患者进行症状评估,并给予管理和控制.     

肺癌患者化疗相关症状群的发生现状及影响因素分析

目的 了解肺癌患者化疗相关症状群的发生现状及其潜在类别,并比较各类别患者在社会、疾病、生理和行为4个方面的差异,分析潜在类别的影响因素。方法 采用便利抽样法,选取2020年10月—2021年11月在广州市某三级甲等医院就诊的肺癌化疗患者作为调查对象。采用一般资料调查表、国际体力活动问卷-短卷、锻炼自我效能量表、简明疼痛量表、简明疲乏量表、阿森斯失眠量表、患者健康问卷-抑郁筛查量表收集资料。采用Mplus 8.3软件进行潜在类别分析,并应用SPSS 25.0软件进行单因素和Logistic回归分析,确定潜在类别的影响因素。结果 回收有效问卷294份,有效问卷回收率为91.88%,其中84.4%的肺癌患者存在化疗相关症状群。潜在类别分析结果显示,存在高症状组（53.6%）和低症状组（46.4%）2个类别。Logistic回归分析结果显示,工作状况、BMI、体力活动水平、锻炼自我效能量表得分、确诊时间和白蛋白浓度是肺癌患者化疗相关症状群潜在类别的影响因素。结论 肺癌患者化疗相关症状群的发生率较高,症状特征存在异质性,可分为2个潜在类别。无业、BMI<18.5以及每周体力活动水平、锻炼自...     

肺癌患者出入院期间症状群严重程度现状调查

目的:调查肺癌患者住院及出院期间症状群严重程度现状。方法:选取90例肺癌患者,采用安德森症状评估量表与肺癌症状模块进行问卷调查,且于治疗后3、6个月进行随访。结果:两次评估一致症状群主要为肺癌特异性症状群、心理症状群、疲劳症状群、化疗症状群;部分症状群会伴随疾病发展,其中疲劳症状群是最关键症状群,其与心理等症状群彼此影响。结论:护理人员应按照肺癌患者不同症状群的不同严重程度,有针对性地设计科学的症状管理护理措施,逐渐完善其症状管理护理模式,有助于肺癌患者疾病康复。     

Symptom clusters and relationships to symptom interference with daily life in Taiwanese lung cancer patients

The number one cause of cancer death in Taiwan is lung cancer. Of the few studies describing the experience of patients living with lung cancer, most use bivariate analyses to test associations between individual symptoms. Few have systematically investigated multiple symptoms. This prospective study was undertaken to explore the phenomenon of symptom distress, to investigate the presence of symptom clusters, and to examine the relationship of symptom clusters to symptom interference with daily life in Taiwanese lung cancer patients. A sample of 108 lung cancer patients was recruited using the Taiwanese version of the M. D. Anderson Symptom Inventory. Data were analyzed by hierarchical cluster analysis, factor analysis, Pearson correlation, t-test, and regression analysis. The top five most-severe symptoms were fatigue, sleep disturbance, lack of appetite, shortness of breath, and general distress. Factor analysis generated a two-factor solution (general and gastrointestinal symptoms) for symptom severity items. Consistent with the result from factor analysis, cluster analysis also indicated the same two cluster groups (general and gastrointestinal symptoms). Both clusters were significantly correlated with symptom interference items; however, the general symptom cluster presented higher correlation coefficients than did the gastrointestinal symptom cluster. These results provide an important basis for developing novel strategies to manage multiple symptoms in lung cancer patients and thereby improve their well-being.     

胃癌患者围手术期症状群的纵向研究

目的 明确胃癌患者围手术期所经历症状群的种类、构成及动态变化,为有效实施症状管理提供参考依据.方法 采用一般资料调查问卷和安德森消化道癌症症状评估量表对109例胃癌患者于手术前1 d(T1)、手术后3 d(T2)和手术后7 d(T3)3个时间点进行纵向调查,通过探索性因子分析确定症状群.结果 T2时症状数量、发生率以及...     

食管癌患者放疗相关性症状簇对其生活活动功能影响的研究

目的分析食管癌患者发生的放疗相关性症状簇现象,探讨其对生活活动功能的影响。方法对105例食管癌放疗患者,应用中文版安德森症状调查量表进行评估。结果食管癌患者存在放疗相关性症状簇,随放疗时间的延长,症状程度加重。放疗次数、同时患合并症数目、宗教信仰对症状总分的影响有统计学意义。结论食管癌患者放疗期间存在放疗相关性症状簇,症状簇对患者生活活动功能产生影响。     

Symptom Burden Clusters: A Challenge for Targeted Symptom Management. A Longitudinal Study Examining Symptom Burden Clusters in Breast Cancer

ContextAlthough there has been a growing interest in cancer symptom clusters, less is known about symptom burden clusters.ObjectivesTo explore clusters of burdensome symptoms over time, the impact on health status and quality of life, and coping capacity in patients with breast cancer.MethodsIn this longitudinal study, a sample of 206 patients completed the Memorial Symptom Assessment Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and the Sense of Coherence scale, at diagnosis of primary or recurrent breast cancer, and at one-, three-, and six-month follow-ups.ResultsThree clusters of burdensome symptoms were identified: emotional symptom burden, gastrointestinal symptom burden, and unwellness symptom burden. Most burdensome were emotional symptoms, with worrying, feeling sad, and feeling nervous as the core or defining symptoms. Over time, additional symptoms escalated the emotional symptom burden. The gastrointestinal symptom burden, with “change in the way food tastes” as a core symptom, was more often associated with chemotherapy. Less stable over time, the unwellness symptom burden could be interpreted as short- and long-term side effects of hormonal therapy. Of these clusters, only the emotional symptom burden cluster significantly diminished health status and quality of life. Patients reporting lower coping capacity experienced higher levels of symptom burden.ConclusionThis study provides insights into symptom burden clusters over time. A challenging approach toward symptom management in clinical oncology is to target the burden of a symptom cluster and to recognize the need for individually designed interventions to ameliorate symptom burden in cancer patients.     

The Role of Inflammation in the Pain,Fatigue, and Sleep Disturbance Symptom Cluster in Advanced Cancer

Context

Symptom researchers have proposed a model of inflammatory cytokine activity and dysregulation in cancer to explain co-occurring symptoms including pain, fatigue, and sleep disturbance.

Symptom clusters: concept analysis and clinical implications for cancer nursing

The purpose of this article is to analyze the concept of symptom clusters and to discuss its application to cancer nursing to promote communication and enhance scientific knowledge. Rodgers' evolutionary method of concept analysis served as the framework for reviewing literature from psychology/psychiatry, general medicine, and nursing. Attributes of symptom clusters were relationships of symptoms and relationships of clusters, concurrence, underlying dimensions, stability, and common etiology. The major antecedent was the presence of 2 or more symptoms. Consequences were poorer physical health status, interference with activities of daily living, emotional distress, and increased financial burden. A symptom cluster is defined as consisting of 2 or more symptoms that are related to each other and that occur together. Symptom clusters are composed of stable groups of symptoms, are relatively independent of other clusters, and may reveal specific underlying dimensions of symptoms. Relationships among symptoms within a cluster should be stronger than relationships among symptoms across different clusters. Symptoms in a cluster may or may not share the same etiology. Symptom should be broadened to include both subjective (self-reported) symptoms and objective (observed) signs. Implications for researchers include the need to use a clear definition, determine the optimal methods of identifying etiology and nature of symptom clusters in various populations, assess the clinical utility of symptom clusters, and test interventions. Implications for practitioners include the need to comprehensively assess symptoms over the entire cancer trajectory, select interventions that target single and multiple symptoms, and evaluate outcomes that include quality of life and economic variables.     

Stability of Symptom Clusters in Patients With Lung Cancer Receiving Chemotherapy

Context

Patients with lung cancer who undergo chemotherapy (CTX) experience multiple symptoms. Evaluation of how these symptoms cluster together and how these symptom clusters change over time are salient questions in symptom clusters research.

需求理论下肺癌化疗患者对消化道症状群认知态度及饮食营养管理需求的质性研究

目的：探究需求理论下肺癌化疗患者对消化道症状群的真实认知态度及饮食营养管理需求的质性研究。方法：采用目的抽样方法,选取2021年10～11月南昌市某三甲医院呼吸科收治的16例肺癌化疗患者为研究对象,进行半结构式深入访谈,并运用现象学分析法进行资料分析。结果：通过访谈归纳出三个主题,分别是肺癌化疗患者普遍出现消化道症状但缺乏多渠道的正向行为;肺癌化疗患者对消化道症状群信息管理平台需求较高;肺癌化疗患者出现消化道不适症状时,对营养、饮食的信息需求较大。结论：医护人员应准确评估患者对消化道症状群的认知情况及饮食营养管理需求,实现对消化道症状群的科学管理,提高患者营养水平和生活质量。     

Symptom clusters and symptom interference of HCC patients undergoing TACE: a cross-sectional study in China

Objective

The aim of this study was to investigate the symptom and symptom clusters of patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE), and to discuss the relationship between symptoms, symptom clusters, and symptom interference.

Materials and methods

Patients with HCC who received TACE were asked to rate their symptoms using the M. D. Anderson Symptom Inventory and the symptom checklist particularly for HCC. To determine the interrelationships among symptoms and identify the symptom clusters, a principal component analysis with varimax rotation was carried out on the symptom items. Spearman correlation analysis was done to assess the relationship between symptom clusters and symptom interference.

Results

A total of 155 patients finished the whole procedure between November 2010 and May 2011. Before TACE, the five most severe symptoms, ranked in order, were fatigue (3.40?±?2.26), distress (3.35?±?2.60), sadness (3.01?±?2.66), sleep disturbance (2.63?±?2.57), and lack of appetite (2.26?±?2.38). After TACE, fatigue (4.88?±?2.31) was the most serious symptom, followed by sleep disturbance (4.80?±?2.25), distress (4.59?±?2.32), sadness (4.45?±?2.16), lack of appetite (4.25?±?2.51). Two symptom clusters were found before TACE: psychological symptom cluster and sickness symptom cluster. Two new symptom clusters were found after TACE: upper gastrointestinal symptom cluster and liver function impairment symptom cluster, with the two original symptom clusters remained relatively stable. The highest symptom interference items pre- and post-TACE were work and enjoyment of life, followed by mood. The symptoms of distress, sadness, fatigue, sleep disturbance, and lack of appetite were all significantly associated with the total interference (r?=?0.443–0.615, p?<?0.01 or p?<?0.05). Symptom clusters were significantly correlated with the total symptom interference before and after TACE (r?=?0.176–0.638, p?<?0.01 or p?<?0.05).

Conclusion

Psychological symptom cluster and sickness symptom cluster are common for HCC patients before and after TACE. Liver function impairment and upper gastrointestinal symptom clusters are directly related to TACE treatment. Both the symptoms and symptom clusters have significant interference on the daily life of HCC patients undergoing TACE. However, more work is needed to further clarify the symptom clusters associated with TACE and to test the effectiveness of TACE in easing symptoms and improving quality of life of HCC patients.