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。

Symptom Distress of Patients with Postoperative Breast Cancer and Its Correlation with Quality of Life

Objective To investigate the symptom distress of patients with postoperative breast cancer and its correlation with quality of life（QOL） ,so as to provide the evidence for specific symptom management. Methods From January 2010 to January 2011, 126 patients underwent breast cancer surgery were investigated on symptom distress and QOL within 1 week after surgery using the Symptom Distress Scale （SDS） and the European Organization for Research and Treatment of Cancer quality of life questionnaire （EORTC QLQ-C30）. Multivariate regression analysis and Pearson correlation analysis were conducted to explore the influencing factors and the relationship between symptom distress and QOL. Results Symptom distress was common among patients with breast cancer within 1 week after surgery （97.6%0）. The main symptom distress came from the change of appearance, poor outlook, limitations on arm mobility, tightness in the chest wall and pain frequency. Age, stage of breast cancer and type of surgery were the influencing factors. Symptom distress was negatively correlated with QOL （r=-0.31, P〈0. 01）. Conclusion Nurses should always attach more concern to the distress accompanied with breast cancer and the treatment, par ticularly to the young, middle ~advanced stage patients or patients with modified radical mastectomy （MRM）. The improvement of symptom management can also improve to QOL for breast cancer patients.