急性白血病患儿化疗症状群桥梁症状的网络分析  

Bridge symptoms among symptom clusters in children with acute leukemia under-going chemotherapy:a network analysis

作　　者：方加 许丽玲 刘春琴 王妹香 刘琼 黄海英 林艳 Fang Jia;Xu Liling;Liu Chunqin;Wang Meixiang;Liu Qiong;Huang Haiying;Lin Yan(Nursing Department,Guangzhou Women and Children′s Medical Center,Guangzhou Medical University,Guangdong Provincial Clinical Research Center for Child Health,Guangzhou 510623,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心,广东省儿童健康与疾病临床医学研究中心护理部,广东广州510623 [2]广东药科大学护理学院 [3]广州医科大学护理学院 [4]广州医科大学附属妇女儿童医疗中心,广东省儿童健康与疾病临床医学研究中心血液肿瘤科,广东广州510623

出　　处：《护理学杂志》2023年第21期32-37,共6页Journal of Nursing Science

基　　金：广州市卫生健康科技项目(202201020626)。

摘　　要：目的探索急性白血病患儿化疗症状群间的相互关系,识别症状群间的桥梁症状。方法采用便利抽样法,选取586例急性白血病患儿,采用记忆症状评估量表儿童版进行问卷调查。采用网络分析识别症状群间的桥梁症状。结果急性白血病患儿化疗期间存在5个症状群,分别为口腔皮肤症状群、躯体症状群、自我形象受损症状群、消化道症状群与心理症状群。睡眠困难(r bS=0.797,r bC=0.090,r bB=73.000)是症状网络中桥梁强度、桥梁紧密中心性、桥梁中介中心性最高的桥梁症状,其次是感到悲伤(r bS=0.747,r bC=0.075,r bB=30.000)、昏昏欲睡(r bS=0.745,r bC=0.070,r bB=19.000)和“我看起来不像我自己”(r bS=0.612,r bC=0.067,r bB=10.000)。结论急性白血病患儿化疗存在多个桥梁症状连接症状群。症状群桥梁症状有利于简化症状的评估和管理,提高症状管理效率。未来的研究有待开展纵向调查探明症状群变化规律,探索桥梁症状间潜在因果关系和相互影响的机制。Objective To explore the interrelationships among symptom clusters in children with acute leukemia and to identify bridge symptoms between symptom clusters.Methods A total of 586 children with acute leukemia were selected using convenience sampling,and they were investigated by utilizing the Memorial Symptom Assessment Scale 10-18(MSAS 10-18).The network analysis was used to identify the bridge symptoms among the symptom clusters.Results The participants experienced five symptom clusters:oral and skin symptoms,somatic symptoms,self-image disorder symptoms,gastrointestinal symptoms and psychological symptoms.Insomnia(r bS=0.797,r bC=0.090,r bB=73.000)was the bridge symptom with the highest bridge strength,bridge closeness and bridge betweenness in the symptom network,followed by feeling sad(r bS=0.747,r bC=0.075,r bB=30.000),fee-ling drowsy(r bS=0.745,r bC=0.070,r bB=19.000)and"I don′t look like myself"(r bS=0.612,r bC=0.067,r bB=10.000).Conclusion The children with acute leukemia undergoing chemotherapy have several bridge symptoms connecting symptom clusters.The bridge symptoms are helpful in simplifying symptom assessment and management,and improving the efficiency of symptom management.It is recommended to conduct longitudinal investigations to understand patterns of symptom cluster changes,and to explore the potential causal relationships and mechanisms among bridge symptoms.

关 键 词：儿童 急性白血病 症状群 症状管理 桥梁症状 网络分析 护理 

分 类 号：R473.72[医药卫生—护理学]