食管癌病人围术期症状群的纵向研究  

Perioperative symptom clusters in patients with esophageal cancer:a longitudinal study

作　　者：李雯 陈蝶 吴司棋 黎虹 王艺静 曾结 文红英[1] LI Wen;CHEN Die;WU Siqi;LI Hong;WANG Yijing;ZENG Jie;WEN Hongying(Affiliated Hospital of North Sichuan Medical College,Sichuan 637000 China)

机构地区：[1]川北医学院附属医院,四川637000

出　　处：《护理研究》2024年第9期1538-1543,共6页Chinese Nursing Research

摘　　要：目的:调查食管癌病人围术期经历的症状群种类、症状群内症状构成及动态变化,为食管癌病人症状管理提供理论指导。方法:抽取2022年3月—9月在南充市某三级甲等医院胸外科首次行食管癌根治术的病人161例,采用一般资料调查表和食管癌围术期症状评估量表于术前1~3 d(T1)、术后1~3 d(T2)和出院前1~3 d(T3)进行纵向调查,通过探索性因子分析确定症状群。结果:最终纳入154例病人。病人在3个时间点的症状发生率和严重程度不同。探索性因子分析发现食管癌病人在T1存在进食相关症状群、心理症状群、能量不足症状群3个症状群;T2存在进食相关症状群、心理症状群、能量不足症状群、疲乏-疼痛症状群4个症状群;T3存在进食相关症状群、躯体-心理症状群、疲乏-疼痛症状群3个症状群,其中进食相关症状群在围术期稳定存在,且是食管癌病人的特异性症状群。结论:食管癌病人围术期存在稳定的进食相关症状和动态的心理、能量不足、疼痛等症状群,应提前对病人的症状进行评估并实施症状管理,制定针对性的干预计划,以降低手术相关症状对病人的影响。Objective:To investigate the types,composition,and dynamics of symptom clusters experienced by patients with esophageal cancer in the perioperative period,and to provide theoretical guidance for symptom management in patients with esophageal cancer.Methods:A total of 161 patients who underwent radical esophageal cancer surgery for the first time in the Department of Thoracic Surgery in a tertiary care hospital in Nanchong City from March 2022 to September were conveniently selected and longitudinally surveyed using a self-administered general information questionnaire and the Esophageal Cancer Perioperative Symptom Assessment Scale 1~3 days before surgery(T1),1~3 days after surgery(T2)and 1~3 days before discharge(T3),and symptom clusters were identified by exploratory factor analysis.Results:A final total of 154 patients were included.Patients had different incidences and severity of symptoms at the 3-time points.Exploratory factor analysis extracted three symptom clusters of eating-related symptom cluster,psychological symptom cluster,and energy deficit symptom cluster in T1;four symptom clusters of eating-related symptom cluster,psychological symptom cluster,energy deficit symptom cluster,and pain-fatigue symptom cluster in T2;three symptom clusters of eating-related symptom cluster,somato-psychological symptom cluster,and pain-fatigue symptom cluster in T3,among which the eating-related symptom cluster was stable in the perioperative period and was specific to patients with esophageal cancer.Conclusion:There is a stable and dynamic symptom cluster during the perioperative period in patients with esophageal cancer.Patients′symptoms should be assessed,symptom management implemented promptly,and a targeted intervention plan should be developed to reduce the impact of surgery-related symptoms on patients.

关 键 词：食管癌 围术期 症状群 进食相关 心理相关 能量不足 纵向研究 

分 类 号：R473.73[医药卫生—护理学]