基于网络分析肺癌围术期核心症状的调查性研究  

An investigative study on perioperative core symptoms of lung cancer based on network analysis

作　　者：王小波 王慧虹[2] 侯礼佳 吴心艳 张铭栖 刘青 江虹 顾丹凤[2] WANG Xiaobo;WANG Huihong;HOU Lijia;WU Xinyan;ZHANG Mingxi;LIU Qing;JIANG Hong;GU Danfeng(Wuxi Medical College of Jiangnan University,Wuxi 214000,Jiangsu,China;Affiliated Hospital of Jiangnan University,Wuxi 214000,Jiangsu,China)

机构地区：[1]江南大学无锡医学院,江苏无锡214000 [2]江南大学附属医院,江苏无锡214000

出　　处：《护士进修杂志》2023年第24期2333-2339,共7页Journal of Nurses Training

基　　金：江苏省医院协会医院管理创新研究项目(编号:JSYGY-3-2023-125)。

摘　　要：目的探索肺癌围术期症状的发生率及严重程度,并通过网络分析法构造肺癌围术期症状网络,识别核心症状。方法于2023年3-9月在天锡市某三甲医院便利抽样选取301例肺癌围术期患者,采用安德森症状量表(中文版)及肺癌特异性症状模块(修订版)进行相关症状的调查,经单因素及多因素回归分析筛选有显著意义的影响因素,并通过R语言网络分析法,构建有影响因素和无影响因素的症状网络,分析中心性指标,确定核心症状。结果肺癌围术期发生率高的症状是疼痛、疲劳、气短,最严重的症状依次是疼痛、疲劳、苦恼。单因素、多因素线性回归分析结果显示,手术方式、并发症、家庭人均月收入、病程是影响肺癌围术期症状的影响因素(P<0.05)。在有影响因素和无影响因素的症状网络中,强度、紧密中心度、中介中心度最高的症状都是气短(r s=1.19、r c=0.0055、r b=40)。疼痛(r s=1.07)和疲劳(r s=1.04)强度中心度仅次于气短。结论肺癌围术期核心症状是气短,护理人员应优先干预,并重点关注疼痛和疲劳症状,以提高肺癌围术期症状管理效率和精准度。Objective To explore the incidence and severity of perioperative symptoms in patients with lung cancer,and construct a network of perioperative symptoms of lung cancer through network analysis to identify core symptoms.Methods A total of 301 perioperative patients with lung cancer were selected by convenient sampling,and related symptoms were investigated by the Anderson Symptom Scale(Chinese version)and Lung Cancer-Specific Symptom Module(revised version),and single and multi-factor regression analysis were used to screen for significant effects factors,and a symptom network of influential factors and non-influential factors was constructed through the R language network analysis method,the centrality index was analyzed,and the core symptoms were determined.Results The symptoms with high incidence of perioperative lung cancer were pain,fatigue,and shortness of breath,and the most serious symptoms were pain,fatigue,and distress in order.The results of single-factor and multi-factor linear regression analysis showed that surgical method,complications,family per capita monthly income,and disease duration were influencing factors of perioperative symptoms of lung cancer(P<0.05).In the symptom network with and without influencing factors,the symptom with the highest intensity,closeness centrality,and betweenness centrality were shortness of breath(r s=1.19,r c=0.0055,r b=40).The intensity centrality of pain(r s=1.07)and fatigue(r s=1.04)was second only to shortness of breath.Conclusion The core perioperative symptom of lung cancer is shortness of breath.Nursing staff should prioritize intervention and focus on pain and fatigue symptoms to improve the efficiency and accuracy of perioperative symptom management of lung cancer.

关 键 词：网络分析 核心症状 症状管理 肺癌 气短 疼痛 疲劳 

分 类 号：R47[医药卫生—护理学] R473.73[医药卫生—临床医学]