乳腺癌术后化疗患者症状群的纵向研究  

Longitudinal analysis of symptom clusters in chemotherapy patients after breast cancer surgery

作　　者：祝龙玲 蒋晓莲[1] 彭维雪 程静霞 左乾涛 Zhu Longling;Jiang Xiaolian;Peng Weixue;Cheng Jingxia;Zuo Qiantao(West China School of Nursing/West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西护理学院/四川大学华西医院,四川成都610041

出　　处：《护理学杂志》2022年第20期23-27,共5页Journal of Nursing Science

摘　　要：目的调查乳腺癌术后化疗患者不同时间点症状群构成及动态变化,为乳腺癌患者症状管理提供参考。方法抽取乳腺癌术后化疗患者为研究对象,收集患者一般人口学资料、疾病资料,采用中文版记忆症状评估量表在化疗前2 d(T1,200例)、第1次化疗1周后(T2,179例)、第3次化疗1周后(T3,164例)对患者进行评估。结果3个时间点症状数目比较,差异有统计学意义(P<0.05);T1~T3各时间点发生率大于20%的症状数目分别为9、24、26个。探索性因子分析显示,乳腺癌术后化疗患者在T1、T2、T3分别提取3、6、6个症状群,其中心理症状群、自我形象紊乱症状群、激素相关症状群持续存在于T1~T3,消化道症状群、食欲相关症状群和认知相关症状群存在于T2~T3。结论乳腺癌术后化疗患者存在多种症状群,随化疗的开展而增多,症状群的核心症状随时间的推移相对稳定。医护人员应重视患者症状群的动态变化,采取针对性干预措施,以最大限度地减轻乳腺癌术后化疗患者的症状负担。Objective To investigate longitudinally the types and dynamic changes of symptom clusters in chemotherapy patients after breast cancer surgery.Methods By the convenience sampling method,164 chemotherapy patients after breast cancer surgery were surveyed by using the general demographic data questionnaire,the disease data questionnaire,the Memorial Symptom Assessment Scale before chemotherapy(T1,n=200),after the first chemotherapy(T2,n=179),and after the third chemotherapy(T3,n=164).Results The number of symptoms at different time points in breast cancer patients on chemotherapy varied significantly(P<0.05).Symptom counts with an incidence rate greater than 20%were 9 at T1,24 at T2,and 26 at T3.Respectively,3,6,and 6 symptom clusters were extracted from T1 through T3.Psychological symptom cluster,self-image disorder cluster and hormone-related symptom cluster persisted at all time points,while gastrointestinal symptom cluster,appetite-related symptom cluster and cognitive symptom cluster persisted at T2 and T3.Conclusion There are multiple symptom clusters in chemotherapy patients after breast cancer surgery,and the core symptoms of the symptom clusters are relatively stable over time.It is suggested that medical staff should pay attention to the dynamic changes of patients′symptom clusters,and take more targeted intervention measures,in a bid to reduce symptom burdens of chemotherapy patients after breast cancer surgery.

关 键 词：乳腺癌 化疗 症状群 心理症状 自我形象紊乱 消化道症状 症状管理 症状困扰 纵向研究 

分 类 号：R473.73[医药卫生—护理学]