对249例癌症患者症状的调查

目的了解癌症患者症状的程度、症状对生活的影响以及在癌症患者症状控制工作中存在的问题,从而为控制、改善患者的症状,提高其生活质量提供有效的方法和对策.方法应用美国M.D.Anderson癌症研究中心制定的MDASI症状评估量表对249例癌症患者本人及52名护士进行问卷调查.结果在癌症患者常见的13项症状中,疲乏、睡眠不安、抑郁、疼痛、食欲差5项症状程度较重,其中以疲乏最为显著;由于这些症状的干扰,癌症患者的生活受到极大影响,突出表现在对工作的影响上.护士对患者症状的评估与患者自身的评估基本一致,但准确度不足,护士的评估分值低于患者的自评分值.结论护士应综合、全面地做好症状控制;积极改善症状对癌症患者生活质量的影响;重视患者主观感觉,并使用良好的评估工具,从而提高护士对症状评估的准确性.     

糖尿病足溃疡患者症状群评估工具的研究进展

糖尿病足溃疡患者因疾病本身、治疗方式等特殊性,常伴有多重症状,严重困扰患者。评估症状群可以了解患者经历的症状,有助于联合管理。本研究总结了国内外糖尿病足溃疡患者症状群评估工具的内容、特点及应用情况。建议根据现有普适性工具的特点并结合糖尿病足溃疡疾病特点,开发适合糖尿病足溃疡患者症状群的特异性评估工具,为有效管理患者的症状,提升其生活质量提供依据。     

乳腺癌术后患者的症状困扰及其与生活质量的相关性

目的探讨乳腺癌术后患者的症状困扰及其与生活质量的相关性,为进行有针对性的症状管理提供依据。方法于2010年1月至2011年1月以便利抽样法选取哈尔滨医科大学附属第一医院行乳腺癌手术的患者126例,采用症状困扰量表（the symptom distress scale,SDS）、欧洲癌症研究与治疗组织生活质量问卷（ European Organization for Researchand Treatment of Cancer quality of life questionnaire, EORTC QLQ-C30）调查乳腺癌患者术后l周内的症状困扰和生活质量,进行多元逐步回归分析和Pearson相关分析。结果乳腺癌术后1周内患者普遍存在症状困扰（97．6％）,困扰程度最高的症状依次为外表的改变、对前景的担忧、手臂活动受限、胸壁紧张感、疼痛频率;年龄、疾病阶段、手术方式是症状困扰的影响因素;症状困扰与生活质量之间呈负相关（r=-0．31,P〈0．01）。结论护理过程中应重视疾病和治疗带给患者的症状困扰,对年轻、中晚期和乳房全切患者应给予更多关注,加强症状管理,进而提高乳腺癌术后患者的生活质量。     

癌症患者症状群概述及识别方法的研究进展

本文对癌症患者症状群、前哨症状、核心症状等概念、识别统计方法、存在问题等进行综述,帮助临床医护人员采用科学方法识别症状群,开发个体化癌症症状管理干预措施,改善患者机体功能及生活质量。     

头颈癌患者症状群的研究进展

头颈部癌症是全球癌症负担的重要组成部分,是全球第7大常见恶性肿瘤。患者在疾病及治疗进程中普遍经历多种症状,常聚集成群,给其带来严重身心困扰。本文从头颈癌患者症状群的发生现状、评估工具、研究方法、影响因素及护理干预5个方面全面进行综述,以期为头颈癌患者临床评估及干预管理提供参考。     

恶性肿瘤伤口患者症状生活困扰现状及其影响因素分析

目的 ：调查恶性肿瘤伤口患者症状生活困扰水平并分析其影响因素。方法 ：采用便利抽样法,于2019年1月至2021年5月在南宁市某三级甲等医院选取132名恶性肿瘤伤口患者作为研究对象,使用一般资料调查表和症状生活困扰评估量表等工具进行调查,评估恶性肿瘤伤口患者症状生活困扰水平并运用多元线性回归分析其影响因素。结果 ：恶性肿瘤伤口患者症状生活困扰总分为（55.42±14.21)分,其中功能状态维度为（19.50±4.73)分、社会关系维度为（17.50±6.12)分、心理健康维度为（18.42±4.55)分。多元线性回归结果显示,性别、伤口渗液量、伤口气味、伤口瘙痒、换药频率、心理痛苦是恶性肿瘤伤口患者症状生活困扰的影响因素（P<0.05）,可解释总变异的79.7%。结论 ：恶性肿瘤伤口患者症状生活困扰水平较高,应关注患者伤口或肿瘤相关症状,帮助患者做好症状管理,引导患者积极应对现存症状和疾病,予以心理支持与疏导,提升患者生活质量。     

癌症患者多症状测评工具的研究进展

症状指的是“个体的主观体验,反映个体的生物、心理、社会功能以及感知觉和认知的变化”。癌症本身及各种治疗常使患者产生多种并存症状,这些症状对患者的治疗依从性和生活质量均会造成负面影响。因此,有必要对癌症患者的症状进行有效管理,而对症状进行有效管理的前提在于选用合适的症状测评工具。尽管目前已出现一些癌症患者症状测评工具,但尚无各测评工具的测评质量汇总比较的中文文献报道。     

癌症患者症状群干预方法的研究进展

随着国内外专家对症状管理的不断深入研究发现,在癌症患者所经历的多种症状中,一些症状有集群的趋势,这些集群的症状相互关联、互相影响,并以症状群的形式发生与发展。针对症状群进行干预可以发挥症状间的协同、强化作用,减轻患者症状负担、节约卫生资源。本文阐述了症状群的概念,对癌症患者症状群的各种干预方法进行综述,并对今后研究提出展望,以期为进一步缓解癌症患者症状压力、提高其生活质量提供参考。     

OSAHS患者症状困扰与生活质量的相关性研究

目的:了解睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea hypopnea Syndrome,OSAHS)患者症状困扰现状,并分析其与生活质量的相关性,为临床护理措施的制定提供一定的理论依据。方法:采用M.D.Anderson症状量表和SF-36生活质量量表对福建医科大学附属第一医院呼吸与危重症医学科的120例OSAHS患者进行调查。结果:OSAHS患者症状困扰发生率为100%,120例患者13项症状评分为41.32±16.19分,6项症状对患者生活的影响程度评分为14.02±8.75分,OSAHS患者生活质量低于四川常模(P0.05);13项症状困扰分别和躯体角色、身体疼痛、总健康、生命力、社会功能、情感角色、心理健康7个维度评分呈负相关,6项症状对患者生活的影响评分和躯体功能、躯体角色、总健康、社会功能、情感角色5个维度评分呈负相关。结论 OSAHS患者均有不同程度的症状困扰,症状困扰程度与生活质量呈正相关;应重视患者症状的评估和管理,降低症状困扰程度,改善患者生活质量。     

前列腺癌患者症状评估工具的研究进展

前列腺癌疾病症状及治疗所引起的并发症对前列腺癌患者的生活质量造成了严重的影响。对患者开展症状评估有利于判断疾病进展情况及预后情况, 同时可为患者症状管理及后续治疗提供依据, 从而提高其生活质量。本文对前列腺癌症状评估工具进行综述, 包括各评估工具测评内容、信效度、评分方法、应用现状及评价等, 旨在为前列腺癌患者症状评估工具的选择及开发提供参考依据。     

Symptom distress and quality of life in patients with advanced congestive heart failure

Little is known about the burden of illness associated with advanced congestive heart failure (CHF). Understanding the needs of this population requires further information about symptoms and other factors related to quality of life. We studied a convenience sample of 103 community-dwelling patients with New York Heart Association Class III/IV CHF. The primary outcome, quality of life, was measured with the Multidimensional Index of Life Quality. Potential correlates of quality of life included overall symptom burden (Memorial Symptom Assessment Scale, MSAS), including global symptom distress (MSAS Global Distress Index, GDI); psychological state (Mental Health Inventory-5); functional status (Sickness Impact Profile); spirituality (Functional Assessment of Chronic Illness Therapy-Spirituality Scale); and co-morbid conditions (Charlson Comorbidity Index). Patients had a mean age of 67.1 years (SD=12.1); were mostly white (72.8%), male (71.8%), and married (51.5%); and had a mean ejection fraction of 22.3% (SD=6.8). The most prevalent symptoms were lack of energy (66%), dry mouth (62%), shortness of breath (56%), and drowsiness (52%). Pain was reported by about one-third of patients. For each of these symptoms, high symptom-related distress was reported by 14.1%-54.1%. Quality of life was moderately compromised (Multidimensional Index of Life Quality composite, median=56, possible range 12-84). Impairment in quality of life was strongly associated with global symptom distress (MSAS GDI; r=0.74, P<0.001); burden of comorbid conditions (r = -0.32, P=0.002), female sex (r=-0.22, P=0.03), functional impairment, particularly psychological impairment (r=-0.55, P<0.001), and poorer psychological well-being (r=0.68, P<0.001). In multivariate analyses, impairment in quality of life was significantly related to high symptom distress, poorer psychological well-being, and poor functional mobility (R2=0.67; P=0.002 for all). Distressful symptoms related to impaired quality of life included lack of energy (P=0.04), irritability (P=0.03), and drowsiness (P=0.02). Community-dwelling patients with advanced CHF experience numerous symptoms, significant symptom distress, and a compromised quality of life. Overall quality of life was strongly associated with symptom distress, psychological well-being and functional status. A focus on ameliorating prevalent physical symptoms and psychological distress, along with supportive measures that promote functional mobility, may lead to an improvement in the overall quality of life in this patient population.     

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.

Measuring symptom occurrence and symptom distress: development of the symptom experience index

AIM: This paper is a report of a study to assess reliability and construct validity of revised and refined version of the Adapted Symptom Distress Scale: the Symptom Experience Index (SEI). BACKGROUND: The development of the SEI, a 41-item Likert Scale assessing 20 symptoms, was based on self-regulation theory and an integrative conceptual analysis of symptom assessment and management. The model emphasizes the difference between the occurrence of a symptom (or multiple symptoms) and the distress (emotional) response to the occurrence of a symptom. It is the distress from symptom occurrence that promotes a person to take action and use known coping strategies to prevent the symptom occurrence or alleviate the distress from the symptom. METHOD: A contrast-group and test-retest approach was used to assess construct validity and reliability with a convenience sample of 158 patients at United States of America in 2003-2004. RESULTS: The SEI demonstrated reasonable internal consistency with a Cronbach's alpha of 0.91 for symptom experience, 0.85 for symptom occurrence and 0.84 for symptom distress. Test-retest reliability was supported by high intra-class correlation coefficients (symptom experience r = 0.93; symptom occurrence r = 0.94; symptom distress, r = 0.92). Construct validity was supported by statistically significant differences between patients and healthy adults. CONCLUSION: The SEI can be used as a baseline and outcome measure to assess the impact of multiple symptoms on patients, and the effectiveness of interventions to manage these symptoms.     

肺癌患者化疗期间的症状群及其对日常生活的影响

目的调查肺癌患者化疗期间的症状群及其对患者日常生活的影响。方法采用中文版安德森症状评估表对183例化疗期间的肺癌患者进行调查,通过因子分析提取肺癌患者化疗期间的症状群,通过回归分析探讨症状群对患者日常活动的影响。结果肺癌患者化疗期间存在胃肠道症状群、情绪症状群、疲乏相关症状群。三大症状群对患者日常活动的困扰有显著影响(P<0.01),可解释总变异的76.2%。结论肺癌患者症状发生频率高、程度重,存在多个症状群,并且严重影响日常活动。护士应该准确及时地进行症状评估,积极对症状群进行管理与控制,以改善患者的生活质量。     

癌症化疗病人睡眠质量与症状困扰、心理状态的相关性研究

[目的]探讨癌症化疗病人住院期间睡眠现状及与化疗期间症状困扰和心理状态的相关性,为癌症化疗病人的临床护理提供参考和指导。[方法]应用一般人口学资料问卷、匹兹堡睡眠质量指数量表、安德森症状评估表（MDASI C）及综合医院焦虑抑郁量表（HADS）对北京市某2所三级甲等医院胸外科、肿瘤科、妇科的95例癌症化疗病人进行调查,并对睡眠质量与症状困扰、心理状态的相关性进行分析。[结果]癌症化疗病人住院期间睡眠质量好者3例（3.2%）,一般16例（16.8%）,差者76例（80.0%）;癌症化疗病人住院期间睡眠质量指数与化疗症状困扰、心理状态呈正相关（P=0.000）。[结论]大多数癌症化疗病人住院期间睡眠质量差,睡眠质量与化疗症状困扰和焦虑抑郁程度呈正相关。临床工作中应考虑症状和心理状态对病人睡眠的影响,有针对性地对病人的睡眠进行健康教育。     

The symptom burden of patients with hematological malignancy: a cross-sectional observational study

Context

Current literature suggests that contact with specialist palliative care for patients diagnosed with hematological malignancy is infrequent. As part of an investigation into patterns of care, the symptom profile of this patient group required elucidation.

Objectives

The purpose of this study was to determine the patterns of symptoms and level of distress in patients diagnosed with a hematological malignancy.

Methods

One hundred eighty patients diagnosed with a hematological malignancy attending a tertiary referral hospital completed the Memorial Symptom Assessment Scale-Short Form. Comparisons were made to published symptom prevalence studies of those with nonhematological malignancies.

Results

Patients with hematological malignancy had a considerable physical and psychological symptom burden, with an overall mean of 8.8 (±5.9) symptoms. The mean number of symptoms was significantly greater in those on treatment (P < 0.05), those with poorer performance status (P < 0.001), inpatients (P < 0.01), and those with a more advanced disease stage (P < 0.001) than their respective counterparts. Symptom prevalence ranged from 69% for fatigue to 9% for vomiting. Global, physical, and psychological distress scores were high and varied significantly according to disease stage, Eastern Cooperative Oncology Group status, and patient location. The mean number of symptoms and level of distress were comparable to those patients with metastatic nonhematological malignancy.

Conclusion

Patients with hematological malignancy are likely to have symptom control needs similar to those with metastatic cancer. Because such symptom burden appears to affect those at all phases of illness, comprehensive symptom assessment is suggested throughout. The introduction of palliative care services during times of increased symptom burden may assist hematologists and other carers in the management of their patients’ distress and quality of life.     

哮喘患者的生活质量调查及相关因素分析

目的 探讨哮喘患者的生活质量及相关影响因素.方法 对60例哮喘患者进行一般情况调查、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、健康情况调查问卷(SF-36)评定.结果 除生理机能外,哮喘患者SF-36各维度评分均显著低于常模.病程影响患者的生活质量,病程＞4年患者的生活质量除生理机能评分外均低于病程≤4年的患者,伴有抑郁或焦虑症状的哮喘患者,其SF-36的躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康6个维度评分显著低于不伴抑郁或焦虑症状的患者.结论 哮喘患者的生活质量低于一般正常人群,病程长,伴有抑郁或焦虑症状患者的生活质量受损更加严重.

Abstract：

Objective To explore the quality of life and its related factors of patients with asthma. Methods 60 asthma patients were assessed by Hamilton Rating Scale for Depression(HAMD),Hamilton Rating Scale for Anxiety(HAMA)and the Short-Form-36 Health Survey(SF-36). Results Except physical functioning (PF) domain, the SF-36 score of asthma patients was significantly lower than that of normal. The illness course longer than 4 years had lower score, so did the quality of life. The SF-36 score of asthma patients with depression symptom and anxiety symptom was lower than those without depression symptom and anxiety symptom. Conclusions The asthma patients' quality of life are worse than those of normal, especially the patients with long illness course, depression symptom and anxiety symptom.     

The quality of life of African American women with breast cancer

The objectives of this study were to describe the quality of life of African American women with breast cancer and test a model of factors that may affect their quality of life. A stress-coping framework that included person (demographics, current concerns, and optimism), social resources (family functioning), and illness-related factors (symptom distress, medical characteristics), as well as appraisal of illness and quality of life, was used to guide this exploratory, cross-sectional study. Participants included 98 African American women who were approximately 4 years postdiagnosis. The women reported a fairly high quality of life, were generally optimistic, and had effective family functioning. Although symptom distress was generally low, a sizable number of women reported problems with energy loss, sleep disturbances, and pain. The model explained 75% of the variance in quality of life, with appraisal, family functioning, symptom distress, and recurrence status each explaining a significant amount of the variance. Current concerns had an indirect effect on quality of life that was mediated by appraisal. These findings underscore the importance of helping women foster a positive appraisal of their illness, manage current concerns, maintain family functioning, and reduce symptom distress, because each of these factors indirectly or directly affects their quality of life.