癌症儿童和青少年化疗周期内多症状负担纵向调查分析  

Multi-Symptom Burden of Children and Adolescents with Cancer Within Chemotherapy Cycle:A Longitudinal Study

作　　者：刘砚燕 阮海珊 孙晶[3] 王小龙 沈南平[4] LIU Yanyan;RUAN Haishan;SUN Jing;WANG Xiaolong;SHEN Nanping(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Hematological Oncology,Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Oncology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Nursing,Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine)

机构地区：[1]上海交通大学护理学院,上海200025 [2]上海交通大学医学院附属儿童医学中心血液肿瘤科,上海200127 [3]上海交通大学医学院附属新华医院肿瘤科,上海200092 [4]上海交通大学医学院附属儿童医学中心护理部

出　　处：《军事护理》2022年第7期61-65,共5页MILITARY NURSING

基　　金：国家自然科学青年基金项目(71704106);上海交通大学医学院护理学科建设项目—护理学科骨干人才项目。

摘　　要：目的描述癌症患儿化疗周期内的多症状负担现状及变化,为其症状的精准化管理和干预提供借鉴和参考。方法采用便利抽样法选取2019年1-12月在上海市某两家三级甲等医院接受化疗的5~17周岁癌症儿童和青少年,围绕一个骨髓抑制化疗周期的四个时间点(化疗前0~1 d、化疗开始后的2~3 d、开始后的7~10 d和下一疗程开始前1~2 d)进行调查,采用一般资料问卷及回忆症状评估量表(memorial symptom assessment scale,MSAS 10-18)评估癌症患儿化疗期间经历的多个症状。结果84例癌症患儿在化疗开始后2~3 d生理症状负担最高,心理症状负担在新化疗疗程开始前最高,化疗周期内的生理、心理症状、症状困扰指数及MSAS症状负担的变化均具有统计学意义(均P<0.05)。结论癌症患儿在化疗期间受到多种心理、生理症状的困扰且随着治疗时间的变化而变化,医护人员应及时准确地评估患儿化疗周期的症状并给予针对性的管理和干预,从而逐步实现精准、个体化的动态症状管理。Objective To describe the current status and changing trend of the multi-symptom burden of children and adolescents with cancer in a chemotherapy cycle,so as to provide reference for the precise management and intervention of their symptoms.Methods Convenience sampling method was used to select children and adolescents with cancer who were aged from 5 to 17 and received chemotherapy in two tertiary hospitals in Shanghai City from January to December,2019.The survey was conducted at four time points within a chemotherapy cycle accompanying myelosuppression(0 to 1 day before chemotherapy,2 to 3 days after the beginning of chemotherapy,7 to 10 days after the beginning of chemotherapy,1 to 2 days before next cycle).The general information questionnaire and Memorial Symptom Assessment Scale(MSAS 10-18)were used to assess the multiple symptoms that children and adolescents with cancer experienced during chemotherapy.Results The burden of physiological symptoms reached the highest level at 2 to 3 days after the beginning of chemotherapy among the 84 children and adolescents with cancer.The burden of psychological symptoms before a new chemotherapy cycle was found to be the highest.The changes in the physiological and psychological symptoms,symptom distress index,and the MSAS scores within a chemotherapy cycle were statistically significant(all P<0.05).Conclusions Children and adolescents with cancer may suffer from various psychological and physical symptoms which can change within one chemotherapy cycle.Medical staff should timely and accurately assess the symptoms of children and adolescents with cancer during chemotherapy and provide targeted management and intervention,so as to gradually achieve precise,individualized and dynamic symptom management.

关 键 词：儿童 青少年 癌症 化疗 多症状 纵向 

分 类 号：R473.72[医药卫生—护理学] R828.3[医药卫生—临床医学]