鼻咽癌同步放化疗患者症状群的纵向研究  

Changes of Symptom Clusters among Nasopharyngeal Carcinoma Patients undergoing Concurrent Chemoradiotherapy: A Longitudinal Study

作　　者：张娜[1] 宋金霞[2] 王宏桥[2] 周静[2] 金永龙[2] 王园园[2] 孙慧慧 ZHANG Na;SONG Jin-xia;WANG Hong-qiao;ZHOU Jing;JIN Yong-long;WANG Yuan-yuan;SUN Hui-hui(School of Nursing,Qingdao University,Qingdao 266100,China;Affiliated Hospital,Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学护理学院,山东青岛266100 [2]青岛大学附属医院,山东青岛266003

出　　处：《护理学报》2019年第23期6-10,共5页Journal of Nursing（China）

摘　　要：目的纵向探究鼻咽癌同步放化疗患者在不同诊疗时间症状群种类及变化,为延续性症状管理提供参考。方法便利选取118例鼻咽癌同步放化疗患者,采用安德森症状评估量表(头部&颈部模块)在放疗2周末(T1)、放疗4周末(T2)、放疗6周末(T3)及放疗结束后1个月(T4)对患者进行评估,采用探索性因子分析法构建症状群。结果共提取4个症状群,其中疲乏-睡眠-情感症状群、口腔黏膜症状群在T1-T4持续存在,发音-吞咽困难症状群存在于T2-T4,胃肠道症状群仅存在于T2-T3。不同时间点症状群严重程度差异有统计学意义(P<0.05)。结论症状群的动态性不仅体现在严重程度的变化上,还体现在症状群出现时间及内部构成上。医护人员应重视鼻咽癌同步放化疗患者症状群的动态变化,采取更针对性的干预措施。Objective To explore the types and dynamic changes of symptom clusters in nasopharyngeal carcinoma patients with concurrent chemoradiotherapy during different treatment phases and to provide reference for extended symptom management.Methods With convenient sampling method,118 nasopharyngeal carcinoma patients with concurrent chemoradiotherapy were recruited.The MDASI-H&N was used to collect the data at the end of 2,4,6 weeks after radiotherapy(T1,T2,T3 respectively),and 1 month after radiotherapy(T4).Symptom clusters were constructed using exploratory factor analysis.Results Four symptom clusters were extracted,in which fatigue-sleep-emotion symptom clusters and oral mucosal symptom clusters persisted in T1-T4;vocal-dysphagia symptom clusters in T2-T4,and gastrointestinal symptom clusters only existed in T2-T3.The severity of symptom clusters at different time points was statistically significant(P<0.05).Conclusion It is necessary to pay more attention to the dynamic changes of symptom clusters in nasopharyngeal carcinoma patients with concurrent chemoradiotherapy and take targeted interventions based on internal symptoms at each time point.

关 键 词：鼻咽癌 同步放化疗 症状群 纵向研究 

分 类 号：R473.76[医药卫生—护理学]