基于患者报告结局的化疗期乳腺癌患者癌因性疲乏轨迹及影响因素研究  

Trajectory of cancer-caused fatigue in breast cancer patients undergoing chemotherapy based on patient-reported outcomes and its influencing factors

作　　者：温慧 宗旭倩 胡文慧 黄青梅 蔡婷婷 吴傅蕾 袁长蓉 杨瑒[1] WEN Hui;ZONG Xuqian;HU Wenhui;HUANG Qingmei;CAI Tingting;WU Fulei;YUAN Changrong;YANG Yang(Affiliated Cancer Hospital of Fudan University,Shanghai 200032,China;School of Nursing,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院,上海200032 [2]复旦大学护理学院,上海200032

出　　处：《护士进修杂志》2023年第24期2283-2288,共6页Journal of Nurses Training

摘　　要：目的探讨化疗期乳腺癌患者癌因性疲乏的发展规律及其影响因素。方法采用方便抽样法选取2021年10月-2022年3月在我院乳腺科接受化疗的96例乳腺癌患者。采用患者报告结局测量信息系统(PROMIS)-疲乏症状简表测评患者在化疗前(T1)、化疗早期(T2)、化疗中期(T3)及化疗后期(T4)的癌因性疲乏变化,基于增长混合模型探讨癌因性疲乏的轨迹类别并识别其影响因素。结果共纳入96例患者,可分为2类轨迹,命名为症状平缓组(89.4%)和症状缓解组(10.6%)。单因素分析结果显示:化疗前的焦虑、抑郁与化疗期乳腺癌患者的癌因性疲乏发展趋势相关(P<0.05)。结论大部分乳腺癌患者在化疗过程中的癌因性疲乏处于相对平稳的状态,但呈现出较高水平的疲乏,化疗前患者的抑郁和焦虑程度与癌因性疲乏的发展趋势存在相关性,提示临床护理工作者需更加关注焦虑抑郁水平较高的患者的疲乏状态。Objective To explore the development rule of cancer-caused fatigue in breast cancer patients during chemotherapy and analyze its influencing factors.Methods A total of 96 breast cancer patients who received chemotherapy in the breast department of a Grade A hospital in Shanghai from October 2021 to March 2022 was selected by convenient sampling method.Patient-Reported Outcomes Measurement Information System(PROMIS)-Fatigue Short Form was used to evaluate the cancer-caused fatigue levels of patients before(T1),early(T2),middle(T3),and late(T4)chemotherapy.Based on the growth mixed model,the trajectory category of cancer-caused fatigue was discussed and its influencing factors were identified.Results A total of 96 patients were included,which could be divided into 2 categories,named symptom stabilization group(89.4%)and symptom relief group(10.6%).Univariate analysis showed that anxiety and depression before chemotherapy were correlated with cancer-caused fatigue trajectory of breast cancer patients during chemotherapy(P<0.05).Conclusion In the course of chemotherapy,cancer-related fatigue in most breast cancer patients is in a relatively stable state,but presents a high level of fatigue.The degree of depression and anxiety of patients before chemotherapy is correlated with the development trend of cancer-related fatigue,suggesting that clinical nurses need to pay more attention to the fatigue state of patients with high levels of anxiety and depression.

关 键 词：乳腺癌 疲乏 增长混合模型 影响因素 纵向研究 

分 类 号：R473.73[医药卫生—护理学] R737.9[医药卫生—临床医学]