恶性肿瘤患者症状调查及患者日记工具可行性分析  

Prevalence of Symptoms of Cancer Patients and Feasibility of Patient Diary Tool(PDT)

作　　者：邹宝华 吴璇[2] 李占东 俞静[4] 路泽军[5] 李向敏 魏星 王红[8] 李全福[9] 余惠青 宋正波 王楠雅 郭增清[13] 王文博[14] 刘勇[15] 代忠 周琼 赵美庆 黄海力[2] 李小梅 孙红 曹邦伟[4] 康静波[5] 毛志远[6] 金高娃[9] 周福祥[14] 于雷 杨渤彦 丛明华 ZOU Bao-hua;WU Xuan;LI Zhan-dong;YU Jing;LU Ze-jun;LI Xiang-min;WEI Xing;WANG Hong;LI Quan-fu;YU Hui-qing;SONG Zheng-bo;WANG Nan-ya;GUO Zeng-qing;WANG Wen-bo;LIU Yong;DAI Zhong;ZHOU Qiong;ZHAO Mei-qing;HUANG Hai-li;LI Xiao-mei;SUN Hong;CAO Bang-wei;KANG Jing-bo;MAO Zhi-yuan;JIN Gao-wa;ZHOU Fu-xiang;YU Lei;YANG Bo-yan;CONG Ming-hua(National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Chinese People’s Liberation Army General Hospital,Beijing 100039,China;Beijing Cancer Hospital,Beijing 100142,China;Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;The Sixth Medical Center of PLA General Hospital,Beijing,100037,China;Air Force Medical Center,PLA,Beijing 100142,China;Peking University International Hospital,Beijing 102206,China;Beijing Fengtai Hospital,Beijing 100076,China;Erdos Central Hospital,Erdos 017016,China;Chongqing Cancer Hospital,Chongqing 400030,China;The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Basic Medicine and Cancer(IBMC),Chinese Academy of Sciences,Hangzhou 310022,China;The First Bethune Hospital of Jilin University,Jilin 130061,China;Fujian Cancer Hospital,Fuzhou 350014,China;Zhongnan Hospital of Wuhan University,Wuhan 430024,China;Xuzhou Central Hospital,Xuzhou 221009,China;Cancer Hospital of Huanxing Chao Yang Distict,Beijing 100023,China;Sun Huan Cancer Hospital,Beijing 100023,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院,北京100021 [2]中国人民解放军总医院,北京100039 [3]北京大学肿瘤医院,北京100142 [4]北京友谊医院,北京100050 [5]中国人民解放军海军总医院,北京100048 [6]中国人民解放军空军总医院,北京100142 [7]北京大学国际医院,北京102206 [8]北京丰台医院,北京100076 [9]鄂尔多斯市中心医院,内蒙古鄂尔多斯017010 [10]重庆市肿瘤医院,重庆400030 [11]中国科学院大学附属肿瘤医院(浙江省肿瘤医院),中国科学院基础医学与肿瘤研究所,浙江杭州310022 [12]吉林大学白求恩第一医院,吉林长春130061 [13]福建省肿瘤医院,福建福州350014 [14]武汉大学中南医院,湖北武汉430024 [15]徐州市中心医院,江苏徐州221009 [16]北京桓兴肿瘤医院,北京100023 [17]北京三环肿瘤医院,北京100023

出　　处：《中国肿瘤》2021年第12期953-962,共10页China Cancer

基　　金：中国癌症基金会北京希望马拉松专项基金(LC2018A01);吴阶平医学基金会临床科研专项资助基金(320.6750.2021-02-22)。

摘　　要：[目的]分析肿瘤患者在入院时、住院期间及出院时的症状分布及患者日记管理工具在疾病管理中的可行性。[方法]选取全国17家医院的恶性肿瘤患者,向其发放患者日记,指导其如何填写,嘱其每日认真填写日记。通过第三方研究者问询获得并分析患者在住院时、住院期间及出院时的相关症状,通过患者对日记满意度调查与主管医生对日记认可度调查分析患者日记工具的可行性。[结果]共纳入符合要求的152例患者,调查发现肿瘤患者入院时排名前10位的症状分别是疲乏、食量下降(近1周)、疼痛、体重下降(近1个月)、睡眠不好、厌食、胸闷气短、便秘、咳嗽咳痰和心情郁闷;住院期间排名前10位的症状分别是便秘、恶心呕吐、厌食、食量下降(近1周)、腹胀、疼痛、睡眠不好、疲乏、腹泻和发热。出院时排名10位的症状分别是疲乏、便秘、睡眠不好、胸闷气短、疼痛、咳嗽咳痰、厌食、出汗、小便减少、心情郁闷。肿瘤疾病分期为Ⅳ期的患者,入院时的症状患病率明显高于非Ⅳ期患者。绝大部分患者(91.4%,139/152)认可患者日记,认为该患者日记能帮助医生更好的了解自己,65.1%(99/152)的患者表示自己出院后会继续填写该日记内容,82.2%(125/152)的患者表示填写日记不会造成负担。绝大部分主管医生(77.6%,118/152)认为患者日记设计合理,77.0%(117/152)的主管医生认可患者日记并愿意继续使用,75.7%(115/152)的主管医生认为患者日记实用性很强,72.4%(104/152)主管医生认为患者日记能够帮助自己全面了解患者症状,64.4%(98/152)的主管医生认为患者日记能够提高查房效率。[结论]Ⅳ期肿瘤患者相关症状发生率明显高于非Ⅳ期患者,需重点监测和管理。肿瘤患者临床症状在住院期间部分会得以改善,但治疗相关的不良反应使出院时症状又有升高,需要主管医生引起重视并加强出院后随访�[Purposes]To investigate the feasibility of patient diary tool in the symptom prevalence study of hospitalized cancer patients.[Methods]A total of 152 cancer patients with qualified symptom records from 17 hospitals nationwide were enrolled in this study.Patients were asked to fill the diaries under guidance of medical staff every day.The related symptoms of patients before,during and after hospitalization were obtained by third-party researchers.The compliance and acceptance rate of patients and doctors for the diary were analyzed through the survey,and the feasibility of patient diary tool was assessed.[Results]The top ten symptoms of cancer patients when they were admitted to the hospital were fatigue,decreased appetite(for 1 week),pain,weight loss(for 1 month),poor sleep,anorexia,chest condition,constipation,cough and expectoration and depression.The top ten symptoms during hospitalization were constipation,nausea and vomiting,anorexia,decreased appetite(for 1 week),abdominal distension,pain,poor sleep,fatigue,diarrhea and fever.The top ten symptoms at discharge were fatigue,constipation,poor sleep,chest condition,pain,cough and expectoration,anorexia,sweating,decreased urination and depression.The prevalence of symptoms at admission for patients withⅣstage tumor was significantly higher than that of non-Ⅳstage patients.Most of patients(91.4%,139/152)recognized that the patient’s diary could help doctors understanding themselves better,65.1%(99/152)patients said that they would continue to fill in the diary after they were discharged from the hospital,82.2%(125/152)patients said that filling in the diary would not be a burden to them.Most of doctors in charge(77.6%,118/152)thought that the design of patient diaries was reasonable,77.0%(117/152)doctors were willing to continue to use them,and 75.7%(115/152)doctors agreed that patient diaries were very practical,72.4%(104/152)doctors believed that patient diaries could help them fully understand the symptoms of patients,and 64.4%(98/152)doctors believed t

关 键 词：恶性肿瘤 症状 患者日记 简明膳食自评工具 

分 类 号：R73[医药卫生—肿瘤]