中晚期肺癌患者症状和困扰发生的潜在类别分析  

Symptoms and Distress Among Patients in Advanced Lung Cancer:A Latent Class Analysis

作　　者：杨丽敏 刘佳丽 王亚兰[3] 俞娟[3] 覃惠英[2] YANG Limin;LIU Jiali;WANG Yalan;YU Juan;QIN Huiying(Department of Nursing,Affiliated Hospital of Guizhou Medical University,Guiyang 550001,Guizhou Province,China;School of Nursing,Sun Yat-Sen University,Guangzhou 510080,Guangdong Province,China;Department of Internal Medicine,Sun Yat-Sen University Cancer Center,Guangzhou 510060,Guangdong Province,China)

机构地区：[1]贵州医科大学附属医院护理部,贵州贵阳550001 [2]中山大学肿瘤防治中心护理部,广东广州510060 [3]中山大学肿瘤防治中心内科

出　　处：《军事护理》2023年第10期61-65,共5页MILITARY NURSING

基　　金：广东省基础与应用基础研究基金面上项目(2021A1515010718)。

摘　　要：目的探讨中晚期肺癌患者症状体验的潜在类别及相关特征,为实施精准化症状管理干预提供参考。方法2021年9月至2022年1月,采用便利抽样法选取广州市某三级甲等医院住院治疗的中晚期肺癌患者220例为调查对象。采用一般资料调查表和汉化修订版安德森症状评估量表-肺癌模块对其调查,采用潜在类别分析对中晚期肺癌患者症状体验进行分类,并分析社会人口学资料和疾病资料对症状体验潜在类别的影响。结果220例中晚期肺癌患者中,症状报告数量为13(7,19)个,症状严重程度得分为1.36(0.64,2.51)分。其症状体验可分为症状低发-困扰低发组(24.6%)、症状中发-困扰中发组(45.0%)、症状高发-困扰高发组(30.4%)。不同类别患者在症状报告数量、症状严重程度和症状困扰程度方面差异均有统计学意义(均P<0.05)。性别、吸烟情况、有无表皮生长因子受体突变和是否接受免疫治疗是中晚期肺癌患者症状体验潜在类别的影响因素(均P<0.05)。结论中晚期肺癌患者的症状体验存在群体异质性,医护人员应重点关注女性、有吸烟史、有表皮生长因子受体突变、接受免疫治疗患者的症状体验评估和干预。Objective To explore the potential categories and characteristics of symptom experience of patients with advanced lung cancer,and to provide evidence for implementing precise symptom management.Methods From September 2021 to January 2022,the convenience sampling method was used to select 220 patients with advanced lung cancer in a tertiary hospital in Guangzhou.A survey was conducted by general information questionnaire and Chinese version of the Lung Cancer Module of the MD Anderson Symptom Inventory.Latent class analysis(LCA)was used to identify the potential categories.The multinomial logistic regression was used to analyze the influencing factors of potential categories.Results Among 220 patients with advanced lung cancer,the number of symptom reports was 13(7,19),and the symptom severity score was 1.36(0.64,2.51).The symptom experience could be divided into low incidence of symptom and low incidence of distress(24.6%),moderate incidence of symptom and moderate incidence of distress(45.0%),and high incidence of symptom and high incidence of distress(30.4%).There were statistically significant differences in the number of symptom reports,the severity of symptoms and the degree of symptom distress among different categories of patients(all P<0.05).Gender,smoking,with or without epidermal growth factor receptor mutation and whether to receive immunotherapy were the influencing factors of the potential categories of symptom experience in patients with advanced lung cancer(all P<0.05).Conclusion There is group heterogeneity in symptom experience of patients with advanced lung cancer.Health professionals should pay attention to the evaluation and intervention of symptom experience in patients who are women,former smokers,with epidermal growth factor receptor(EGFR)mutation,and receiving immunotherapy.

关 键 词：肺癌 症状体验 潜在类别分析 影响因素 护理 

分 类 号：R473.56[医药卫生—护理学]