成人血液系统肿瘤患者化疗期核心症状及对生活质量的影响  

Analysis of core symptoms during chemotherapy and their impact on quality of life in adult patients with hematological tumors

作　　者：郭秀芳 孟利敏 李婷 曾小青 魏清风[3] 刘怡 王菲菲 林栋美 Guo Xiufang;Meng Limin;Li Ting;Zeng Xiaoqing;Wei Qingfeng;Liu Yi;Wang Feifei;Lin Dongmei(School of Nursing,Gannan Medical University,Ganzhou 341000,China)

机构地区：[1]赣南医科大学护理学院,江西赣州341000 [2]赣南医科大学第一附属医院血液内科 [3]江西省肿瘤医院癌症中心办公室 [4]赣州市肿瘤医院护理部

出　　处：《护理学杂志》2024年第12期25-30,共6页Journal of Nursing Science

基　　金：国家自然科学基金资助项目(72164001);江西省自然科学基金资助项目(20202BABL216019);江西省研究生创新专项资金项目(YC2022-s962)。

摘　　要：目的构建成人血液系统肿瘤患者化疗期的症状网络,识别其核心症状及对生活质量的影响。方法便利选取400例血液系统肿瘤患者,采用一般资料调查表、中文版安德森症状评估量表和简版生活质量量表(SF-12)进行调查。使用R软件构建症状网络,分析中心性指标并确定核心症状;使用单因素分析和分层回归分析探讨核心症状对成人血液系统肿瘤患者生活质量的影响。结果成人血液系统肿瘤患者的核心症状是苦恼,最常见的症状是疲劳、口干和睡眠不安,最严重的症状是疲劳、睡眠不安、食欲下降和苦恼。在症状网络中,强度最大为苦恼(rs=1.2357);紧密中心性和中介中心性最高为疲劳(rc=0.0087,rb=30.0000)。分层回归分析结果显示,在控制一般资料变量后,苦恼和疲劳可解释生理领域总分31.5%的变异,以及心理领域总分31.5%的变异。结论成人血液系统肿瘤患者化疗期的核心症状为苦恼;疲劳处于症状网络的中心位置,与其他症状的接近度高;可将苦恼和疲劳作为靶点制定干预措施,提高成人血液系统肿瘤患者症状管理效能。Objective To construct a symptom network during chemotherapy in adult patients with hematological tumors,and to identify the core symptoms and the impact of core symptoms on quality of life.Methods A total of 400 patients with hematological tumors were easily selected and investigated using a self-made demographic questionnaire,the Chinese version of the M.D.Anderson Symptom Inventory,and the 12-Item Short Form Health Survey(SF-12).R software was used to build symptom networks,analyze central indicators,and identify core symptoms.Univariate analysis and stratified regression analysis were conducted to explore the effect of core symptoms on the quality of life of adult patients with hematological tumors.Results The core symptom of adult patients with hematological tumors was distress.The most common symptoms were fatigue,dry mouth,and disturbed sleep.The most serious symptoms were fatigue,sleep disturbance,decreased appetite and distress.In the symptom network,distress was a symptom with the highest node strength(rs=1.2357);fatigue was a symptom with the highest node closeness and node betweenness(rc=0.0087,rb=30.0000).Stratified regression analyses showed that distress and fatigue explained 31.5%of the variations in the total score in the physical domain after controlling for the demographic variables,and 31.5%of the variations in the total score in the psychological domain after controlling for demographic variables.Conclusion The core symptom in adult patients with hematological tumors during chemotherapy is distress;fatigue is at the center of the symptom network and has a high degree of proximity to other symptoms.Nurses can develop interventions to improve the effectiveness of symptom management in adult patients with hematological tumors by targeting distress and fatigue.

关 键 词：血液系统肿瘤 网络分析 核心症状 生活质量 症状管理 苦恼 疲乏 化疗 

分 类 号：R473.5[医药卫生—护理学]