消化道癌症患者化疗期间症状群及影响因素分析  

Symptom Clusters and Influencing PFactors for Patients with Gastrointestinal Cancer during Chemotherapy

作　　者：冯芳茗[1] 张伟英[2] 何佳倩[1] 顾宏铭 蒋维 马丽莉[2] FENG Fangming;ZHANG Weiying;HE Jiaqian;GU Hongming;JIANG Wei;MA Lili(VIP Depart-ment,Shanghai East Hospital,Shanghai 200123,China;Nursing Department,Shanghai East Hospital)

机构地区：[1]上海市东方医院特诊部,上海200123 [2]上海市东方医院护理部

出　　处：《解放军护理杂志》2020年第9期13-17,共5页Nursing Journal of Chinese People's Liberation Army

基　　金：浦东新区卫生和计划生育委员会优秀青年医学人才项目(PWRq2017-12)。

摘　　要：目的调查消化道癌症患者化疗期间症状群构成,分析各症状群严重程度的影响因素,为实现针对性症状群管理提供参考。方法便利抽样选取2018年1一12月在某三级甲等医院肿瘤专科诊治的消化道癌症患者207例为研究对象,采用一般人口学资料、疾病资料和心理状况调查表(心理一致感量表)安德森症状调查量表对其进行调查;通过探索性因子分析提取症状群,采用多元逐步回归分析影响因素。结果患者化疗期间存在4个症状群,即胃肠道症状群,疲乏-疼痛症状群、心理症状群和神经毒性症状群,累积可解释86.40%的变异;职业状态,文化程度、病程、疾病分期、化疗方案、化疗次数,心理一致感等分别是各症状群严重程度的影响因素(均P<0.05),其中心理一致感对4个症状群的严重程度均有影响。结论医护人员应从症状群角度对患者进行症状管理,并可根据影响因素,对患者实施针对性干预,以实现症状困扰最小化、生活质量最优化。Ohjective To explore the symptorn clusters and influencing factors for patients with gastrointestinal duringchemotherapy,in order to provide references for the targeted management of symnptom clusters.Methods By the conven-ience sampling methd,207 patients with gastrointestiral cancer during chemnotherapy from January to December 2018 werestudied by the general demographic data,disease data,the Sense of Coherence(SOC)scale and MD.Anderson symptominventory.The exploratory factor analysis(EFA)was conducted to analyze the symptom clusters.,The influencing factors ofsymptom clusters were studied by multiple linear regressions.Results There were 4 main symptom clusters,which werenamed gastrointestinal symptom cluster,fatigue-pain symptom cluster,psychological distress symptom cluster and neuro-toxicity symptom cluster.All the symptom clusters could explain 86.4%of the total variance.The influencing factors in-cluded working state,education degree,course of disease,clinical stage,chemotherapy protocol,frequency of chemotherapyand SOC(all P<0.05).SOC was the common factor of four symptom groups.Conclusions Medical staffs should managepatients from the perspective of symptom clusters and carry out integrated interventions for patients based on the influen:cing factors to improve the quality of life while alleviating the burden of patient's symptoms.

关 键 词：消化道癌症 化疗 症状群 影响因素 

分 类 号：R473.57[医药卫生—护理学]