鼻咽癌患者放疗期间症状群变化的纵向研究  

Longitudinal study on the changes of symptom clusters among nasopharyngeal carcinoma patients undergoing radiation therapy

作　　者：吴婉英[1] 杨方英[1] 吴怡[1] 叶彩仙[2] 李卫阳[2] 周慧娟[2] 戴勤[1] 刘淑英[1] Zhou Huijuan Dai Qin Liu Shuying Wu WY Yang FY Wu Y Dai Q Liu SY Ye CX Li WY Zhou HJ(Department, Zhejiang Cancer Hospital, Hangzhou 310022, China Department of Head and Neck Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China)

机构地区：[1]浙江省肿瘤医院护理部,杭州310022 [2]浙江省肿瘤医院头颈放疗科

出　　处：《中华现代护理杂志》2016年第13期1804-1808,共5页Chinese Journal of Modern Nursing

基　　金：浙江省医药卫生科技计划项目（2014KYB040）

摘　　要：目的：探讨鼻咽癌患者放疗期间症状群的动态变化趋势，为临床制定针对性干预措施提供依据。方法选取2014年5月—2015年1月在笔者所在医院治疗的初诊鼻咽癌患者273例，采用自行设计的一般资料问卷及中文版安德森症状评估量表对患者放疗前、放疗中期及放疗结束后3个时间点进行跟踪调查，经单因素方差分析、探索因子分析等对结果进行统计，观察患者放疗期间症状发生情况及症状群的变化。结果3个时间点除健忘症状外，患者其他症状的发生率及强度均随放疗的进行而增强（P ＜0．05）。3个时间点均可聚集成胃肠道症状群、病感症状群及躯体症状群，但不同时间点各症状群内各症状的组成及方差贡献率不同。胃肠道症状群主要由恶心、呕吐症状构成，食欲下降症状仅在放疗前加入该症状群，且该症状群在放疗前最为突出；放疗前病感症状群主要由瞌睡、麻木症状构成，而放疗中及放疗后主要由气短、健忘、麻木症状构成，症状群相对稳定；躯体症状群主要由疼痛、疲乏构成，在放疗中及放疗后2个时间点加入了口干症状。结论随着放射治疗的进行，鼻咽癌患者症状的发生率及强度显著增强，且放疗前、中、后3个时间点，患者症状群的组成出现动态变化。因此，临床护理人员应加强各症状的动态评估，关注患者症状群的变化趋势及内部症状组成，制定针对性的症状管理措施，以提高患者的生活质量。Objective To investigate the dynamic changes of symptom clusters among nasopharyngeal carcinoma patients receiving radiotherapy and provide evidence for intervention clinically.Methods The data were collected at three time points that were before radiotherapy,during the radiotherapy and after radiotherapy, by surveying 273 first visit of nasopharyngeal carcinoma patients from May 201 4 to January 201 5 with a self-designed general information questionnaire and the Chinese version of the M.D.Anderson symptom inventory and observing the changes of symptom clusters in our hospital.One-way analysis of variance and the exploratory factor analysis were applied to observe the incidence of symptoms and the changes of symptom clusters during radiotherapy.Results The statistics revealed that the incidence and intensity of all the symptoms at 3 time points were significantly increased（P 〈0.05）,except the symptom of amnesia.There were 3 symptom clusters among 3 time points,named as gastrointestinal symptom cluster,sickness symptom cluster and somatic symptom cluster,but the composition and the variance were different at different time point.Gastrointestinal symptom cluster was made of nausea and vomiting,adding poor appetite only before radiotherapy.The gastrointestinal symptom cluster was most prominent before radiotherapy.Sickness symptom cluster consisted of drowsiness, numbness symptom before radiotherapy, while it consisted of shortness of breath, numbness, difficulty remembering symptoms in other time.Somatic symptom cluster mainly consisted of pain and fatigue,dry mouth symptom joining it during and after radiotherapy.Conclusions With the treatment of radiotherapy,the incidence and intensity of symptoms are significantly enhanced,and the constitution of symptom clusters is different at different stage.Therefore,it is important for clinical nurses to strengthen dynamic assessment of all symptoms,monitor the changes and composition of symptom clusters,thus establish corresponding management＆amp;nbsp;measures to

关 键 词：纵向研究 鼻咽肿瘤 放射疗法 症状群 

分 类 号：R473.73[医药卫生—护理学]