急性髓系白血病患者诱导缓解治疗期癌因性疲乏轨迹的纵向研究  

A longitudinal study on cancer-related fatigue trajectory in patients with acute myeloid leukemia during remission induction therapy

作　　者：刘晴 胡娟 彭艳妮 鲁桂华 Liu Qing;Hu Juan;Peng Yanni;Lu Guihua(Department of Hematology,The First Affiliated Hospital of Naval Medical University of Chinese PLA,Shanghai 200433,China)

机构地区：[1]中国人民解放军海军军医大学第一附属医院血液病科,上海200433

出　　处：《护理学杂志》2023年第9期39-44,共6页Journal of Nursing Science

摘　　要：目的 探究急性髓系白血病患者诱导缓解治疗期癌因性疲乏的纵向变化轨迹及影响因素,为实施针对性护理干预提供借鉴。方法 采用便利抽样法选取急性髓系白血病行诱导缓解治疗患者183例,采用一般资料调查表、癌因性疲乏评估量表对患者进行调查。采用潜变量增长混合模型识别患者诱导缓解治疗期癌因性疲乏轨迹的不同类别,并分析影响因素。结果 治疗前1 d及诱导缓解治疗1周、2周、3周及结束后1 d患者癌因性疲乏得分分别为22.86±3.75、26.39±4.12、31.71±4.64、36.54±5.25、39.63±5.06,5个时间点得分呈正相关;通过潜变量增长混合模型将其分为持续高疲乏组(48.09%)、疲乏升高组(34.42%)、低疲乏组(17.49%)。多元logistic回归分析显示,与低疲乏组比较,有睡眠障碍、血红蛋白<60 g/L、低社会支持更易归于持续高疲乏组(均P<0.05),有睡眠障碍、并存胃肠道症状群更易归于疲乏升高组(均P<0.05)。结论 急性髓系白血病患者诱导缓解治疗期癌因性疲乏呈现3种潜在类别,医护人员应根据患者癌因性疲乏不同轨迹类别及影响因素制定针对性护理干预方案,以减轻患者疲乏程度。Objective To explore cancer-related fatigue(CRF)trajectory and correlates in acute myeloid leukemia patients during remission induction therapy,and to provide reference for implementing specific interventions.Methods A total of 183 patients with acute myeloid leukemia receiving remission induction therapy were recruited using convenience sampling.They were asked to complete a demographic questionnaire and the Cancer Fatigue Scale(CFS).Latent growth mixture modeling(LGMM)was used to discern distinct trajectories of CFS,and the correlates were analyzed.Results The CFS scores were 22.86±3.75,26.39±4.12,31.71±4.64,36.54±5.25,and 39.63±5.06 at one day before treatment,one,two and three weeks after commence of treatment,and one day after completion of treatment.The CFS scores at 5 time points showed significantly positive correlation.Three CFS trajectory classes were identified:high stable(48.09%of the sample),increasing(34.42%),and low stable(17.49%).Multivariate logistic regression revealed that compared with the low stable trajectory class,predictors for the high stable trajectory were reporting of sleep disorders,hemoglobin<60 g/L,and low social support(all P<0.05),and the increasing trajectory was associated with reporting of sleep disorders and comorbid gastrointestinal symptoms(both P<0.05).Conclusion There are three CFS trajectories in acute myeloid leukemia patients during remission induction treatment.Healthcare personnel should formulate nursing interventions according to distinct developmental trajectories of CFS and the influencing factors,so as to alleviate patients′fatigue.

关 键 词：急性髓系白血病 诱导缓解治疗 癌因性疲乏 睡眠障碍 社会支持 纵向研究 潜变量增长混合模型 

分 类 号：R473.5[医药卫生—护理学]