不同化疗阶段乳腺癌患者生活质量及影响因素研究  

Study on Quality of Life of Patients with Breast Cancer in Different Chemotherapy Phases and its Influencing Factors

作　　者：方琼[1] 吴怡颖[1] 沈莉莉[1] 张男[1] 董晓晶[1] 吴蓓雯[1] FANG Qiong;WU Yiying;SHEN Lili;ZHANG Nan;DONG Xiaojing;WU Beiwen(Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院

出　　处：《上海护理》2019年第9期23-28,共6页Shanghai Nursing

基　　金：上海市科学技术委员会科研计划项目(16411951100);上海市教委护理高原学科项目(Hlgy15001yjx)

摘　　要：目的了解乳腺癌患者接受辅助化疗不同阶段的生活质量现状、变化趋势,分析影响乳腺癌患者化疗末期生活质量的影响因素。方法采用方便抽样法,选取2016年10月1日-2017年1月31日在上海交通大学医学院附属瑞金医院进行化疗的乳腺癌患者。采用一般资料调查表、人体学测量指标、中文版癌症治疗功能评价系统-乳腺癌和国际体力活动评价量表,对首次接受辅助化疗的乳腺癌患者进行问卷调查和纵向跟踪测量。结果乳腺癌患者整个化疗期间生活质量总分平均值为(96.34±14.71)分,其中化疗前期生活质量总分最低为(93.41±13.65)分;不同阶段乳腺癌患者生活质量各维度中除了社会/家庭状况维度,生理状况、情感状况、功能状况和附加关注维度在化疗不同阶段得分差异有统计学意义(P<0.05),其中生理状况维度均分在化疗中期有下降,其余维度均随着化疗进展其生活质量得分逐步提高(P<0.05);经多元线性回归分析显示,化疗药物、体力活动、有无肥胖和职业状态是乳腺癌患者化疗末期生活质量的影响因素(P<0.05),可解释45%的生活质量影响作用(F=6.832,P<0.001,调整R2=0.45)。结论临床护理人员应在乳腺癌患者化疗前期给予更多术后指导及心理护理,化疗中期应注重患者生理状况的护理干预,化疗末期对使用蒽环类化疗药物、缺乏体力活动、肥胖以及退休/无业患者应给予更多关注,指导患者在化疗期间合理活动、控制体重,有益于提高患者的生活质量。Objective To learn about the quality of life of breast cancer patients receiving adjuvant chemotherapy in each chemotherapy phase and its changing trend, and analyze the influencing factors for the quality of life of the patients in the final phase of chemotherapy. Methods Patients with breast cancer undergoing chemotherapy in Ruijin Hospital from October 1, 2016 to January 31, 2017 were selected by convenience sampling. Patients who received adjuvant chemotherapy for the first time were investigated through questionnaire survey and longitudinal follow-up, using general data questionnaire, anthropometric indexes,and the Chinese versions of Functional Assessment of Cancer Therapy-Breast Cancer(FACT-B) and International Physical Activity Questionnaire(IPAQ). Results The mean total score of quality of life of breast cancer patients throughout the chemotherapy was(96.34 ± 14.71), and the lowest total score before chemotherapy was(93.41 ± 13.65). Except for the social/family well-being dimension, the scores in the dimensions of physiological well-being, emotional well-being, functional well-being and additional concerns were statistically significant(P<0.05) in different phases of chemotherapy.The mean score in the physiological well-being dimension decreased in the middle phase, and the scores in other dimensions gradually increased with the progress of chemotherapy(P<0.05). Multiple linear regression analysis showed that chemotherapy drugs, physical activity, obesity and occupational status were the influencing factors that could predict the quality of life of breast cancer patients in the final phase of chemotherapy(P <0.05), and they could account for 45% of the effect on the quality of life(F=6.832, P<0.001, adjusted R2=0.45). Conclusion In the early phase of chemotherapy, clinical nurses should provide more postoperative instructions and psychological care for patients with breast cancer;in the middle phase, they should emphasize nursing intervention on patients’ physiological condition;in the final phase, t

关 键 词：乳腺癌 辅助化疗 生活质量 影响因素 不同阶段 体力活动 

分 类 号：R473.73[医药卫生—护理学]