消化道癌症患者化疗期的症状群及其与心理一致感的关系  

Symptom cluster and sense of coherence in digestive tract cancer patients during chemotherapy

作　　者：王芹[1] 章新琼[1] 王秋萍[1] 吴小婷[1] 葛刘娜 李晓慧[1] 

机构地区：[1]安徽医科大学护理学院,合肥230031

出　　处：《中国心理卫生杂志》2017年第9期685-689,共5页Chinese Mental Health Journal

基　　金：安徽省自然科学基金项目(1608085MH183);安徽省高校人文社科研究项目(SK2015A363)

摘　　要：目的:了解化疗期消化道癌症患者存在的症状群并探讨其与心理一致感的关系。方法:选取安徽省两所三甲医院的化疗期消化道癌症患者212名,采用中文版安德森症状评估量表(MDASI)和心理一致感量表(SOC)进行测评。使用探索性因子分析提取症状群,Spearman相关分析探讨症状群与SOC的关系,并通过聚类分析将症状群划分为高、低分组,采用独立样本t检验比较两组的SOC得分。结果:探索性因子分析结果显示,化疗期消化道癌症患者存在心理症状群、消化道症状群、疲乏-疼痛症状群和神经毒性症状群,累积方差贡献率为64.16%,将疲乏-疼痛症状群依据其症状间相关性的高低分为疲乏症状群和疼痛症状群。5个症状群得分与SOC总分及各维度得分均呈负相关(r=-0.14^-0.57,P﹤0.01或P﹤0.05)。聚类分析得到症状群高分组(n=81)和低分组(n=131),高分组的SOC总分及各维度得分均低于低分组(P﹤0.001)。结论:化疗期消化道癌症患者存在多个生理心理症状群,这些症状群均与心理一致感存在负性关联。Objective： To understand the symptom cluster and its connection with sense of coherence in patients with digestive tract cancer during chemotherapy. Methods： A total of 212 patients with digestive tract cancer during chemotherapy were surveyed with the M. D. Anderson Symptom Inventory（ MDASI） and the Sense of Coherence（ SOC） scale in 2 hospitals in Anhui Province. Exploratory factor analysis were used to extract the symptom clusters. Spearman correlation analysis were used to determine the relationships between the symptom clusters and SOC. Two subgroups were classified based on the scores of symptom clusters by using cluster analysis,and two independent samples t-tests were used to compare the differences between the two groups. Results： According to the factor analysis, four symptom clusters were identified, including psychological symptom cluster, gastrointestinal symptom cluster,fatigue-pain symptom cluster and neurotoxic symptom cluster. The cumulative variance contribution rate was 64. 16%. The fatigue-pain symptom cluster was divided into fatigue symptom cluster and pain symptom cluster according to the correlation. Those 5 symptom clusters were negatively correlated with the SOC（ r =-0. 14--0. 57,Ps ﹤ 0. 05）. Two subgroups were classified based on the cluster analysis,patients in the high-score group（ n = 81） had significantly lower SOC scores（ P ﹤ 0. 001） than those in low-score group（ n = 131）. Conclusion： It suggests that digestive tract cancer patients during chemotherapy could experience several physiology and psychology symptom clusters,which are significantly negatively correlate with the sense of coherence.

关 键 词：消化道癌症 症状群 心理一致感 横断面研究 

分 类 号：R656[医药卫生—外科学] R395.2[医药卫生—临床医学]