鼻咽癌调强放疗患者居家康复期症状特征的潜在类别分析  

Latent class analysis of symptom characteristics of nasopharyngeal carcinoma patients receiving intensity modulated radiation therapy during rehabilitation periodone

作　　者：朱云霞[1] 杨璨 汪和美[1] 陈锃丽[1] 费珍珍[1] ZHU Yunxia;YANG Can;WANG Hemei;CHEN Zengli;FEI Zhenzhen(Department of Head and Neck Oncology Radiotherapy,Zhejiang Cancer Hospital,Hangzhou Institute of Medicine(HIM),Chinese Academy of Sciences,Hangzhou,Zhejiang 310022,China)

机构地区：[1]浙江省肿瘤医院头颈肿瘤放疗科、中国科学院基础医学与肿瘤研究所,浙江杭州310022

出　　处：《中华全科医学》2024年第5期882-886,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划面上项目(2020KY467);浙江省医药卫生科技计划临床应用研究项目(2022KY695)。

摘　　要：目的通过对鼻咽癌患者调强放疗结束后1年症状的随访调查,了解鼻咽癌患者放疗结束后的症状困扰现状以及症状特征的潜在类别,并探讨不同类别患者之间的症状特征差异,为临床护理人员制定针对性的延续性症状管理提供策略。方法采用便利抽样法,选择2020年1月—2021年12月在浙江省肿瘤医院行调强放疗且放疗结束满1年的鼻咽癌患者为研究对象,应用一般资料调查表、头颈部癌症患者特异性生存质量量表QLQ.H&N35进行随访调查,对患者的症状特征进行潜在类别分析,并比较不同类型患者的一般特征。结果共纳入患者156例,患者放疗结束后1年发生率较高的症状有性欲减退(52.6%)、口干(50.6%)、牙齿问题(39.7%),较严重的症状为口干[2.0(1.0,2.0)分]、性欲减退[1.5(1.0,2.0)分];鼻咽癌患者症状特征可分为3个潜在类别,分别命名为低症状反应组(77.56%)、高躯体症状反应组(12.18%)、情绪心理困扰组(10.26%);单因素分析显示三类患者在文化程度、BMI、放疗方式上差异均有统计学意义(P<0.05)。结论鼻咽癌调强放疗患者居家康复期症状特征可分为3个潜在类别,医护工作者应识别不同患者的潜在类别特征,为患者提供延续性的症状随访管理及心理疏导干预,以减轻患者的身心症状反应,改善患者居家康复期间的生活质量,促进康复。Objective To understand the current status of symptom distress and potential categories of symptom characteristics in nasopharyngeal carcinoma patients after radiation therapy by a one-year follow-up of symptoms in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy,and to explore the differences in symptom characteristics among different types of patients to provide strategies for clinical nurses to develop targeted and sustained symptom management.Methods Nasopharyngeal carcinoma patients undergoing intensity-modulated radiation therapy and completing radiation therapy after one year were selected in Zhejiang Cancer Hospital from January 2020 to December 2022.General information questionnaire and QLQ.H&N35 were utilized as the investigating tools.Latent class analysis(LCA)was used to explore the latent classes of the symptom characteristics of nasopharyngeal carcinoma patients,and the general characteristics of different types of patients were analyzed.Results A total of 156 patients were selected.The symptoms with a high incidence rate were hyposexuality(52.6%),dry mouth(50.6%),and dental problems(39.7%)one year after radiotherapy in nasopharyngeal carcinoma patients.Among them,the severity of dry mouth[2.00(1.0,2.0)points]and hyposexuality[1.5(1.0,2.0)points]were higher.The symptom characteristics of nasopharyngeal carcinoma patients could be divided into three latent classes,which were named low symptom response group(77.56%),high physical symptoms response group(12.18%),and emotional psychological distress group(10.26%).One-way ANOVA showed that there were significant differences in education level,BMI,and radiation therapy methods among the three types.Conclusion The symptoms of nasopharyngeal carcinoma patients receiving intensity-modulated radiation therapy during home rehabilitation include three latent classes.Medical workers should identify the latent class to provide continuous symptom follow-up management and psychological counseling intervention for patients,reduce the phy

关 键 词：鼻咽癌 调强放疗 症状特征 潜在类别分析 

分 类 号：R739.6[医药卫生—肿瘤] R730.55[医药卫生—临床医学]