乳腺癌术后患者经济毒性水平及影响因素的纵向研究  

A longitudinal study on the financial toxicity level and its influencing factors in postoperative patients with breast cancer

作　　者：况艺 裘佳佳[2] 汤立晨[2] 刘叶[3] 郭丝锦 陈婷[5] 邢唯杰[1] KUANG Yi;QIU Jiajia;TANG Lichen;LIU Ye;GUO Sijin;CHEN Ting;XING Weijie(School of Nursing of Fudan University,Shanghai 200032,China;Shanghai Cancer Center Affiliated to Fudan University,Shanghai 200032,China;The First Affiliated Hospital of China Medical University,Shenyang 110001,Liaoning,China;The Air Force Medical University,Xian 710032,Shaanxi,China;Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei,China)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属肿瘤医院,上海200032 [3]中国医科大学附属第一医院,辽宁沈阳110001 [4]空军军医大学西京医院,陕西西安710032 [5]华中科技大学同济医学院附属协和医院,湖北武汉430022

出　　处：《护士进修杂志》2024年第19期2023-2030,共8页Journal of Nurses Training

基　　金：国家自然科学基金青年科学基金项目(编号:72004034);China Medical Board Open Competition Program(编号:20-371)。

摘　　要：目的 探讨乳腺癌患者术后不同时间点经济毒性水平的变化趋势及其影响因素。方法 采用前瞻性纵向研究方法,便利抽取2022年11月-2023年3月在复旦大学附属肿瘤医院、中国医科大学附属第一医院、空军医科大学西京医院和华中科技大学同济医学院附属协和医院4所三级甲等医院就诊的447例乳腺癌患者作为研究对象。采用一般资料调查表、患者报告结局的经济毒性综合评分量表、乳腺癌预防试验症状评估量表、记忆症状评估量表简表心理症状分量表、主观社会经济地位量表、领悟社会支持量表及心理弹性测定量表简表分别于术后1周、术后3个月、术后6个月和术后1年对术后乳腺癌患者进行随访调查。结果 共有378例患者完成4次随访调查,有效回收率为84.56%。4个时间点乳腺癌经济毒性的得分依次为(23.47±10.53)分、(22.74±11.37)分、(24.01±10.57)分、(24.24±10.49)分。广义估计方程分析结果显示:居住地类型、可支配家庭存款、是否有商业保险、家庭平均月收入、接受过治疗种类数、主观社会经济地位、社会支持、心理弹性、症状负担是经济毒性水平的影响因素(P<0.05)。结论 乳腺癌患者术后的经济毒性呈先加重后缓解的动态趋势,且受社会人口学因素、疾病及治疗因素和心理因素等多方面因素的影响。未来临床工作者应尽早识别经济毒性的高风险人群并开展干预,且经济毒性的干预方案中应纳入症状负担的管理和监测,为其提供症状管理指导,以及加强心理和社会支持。Objective To explore the changing trends of financial toxicity level in breast cancer patients at different time points postoperatively and its influencing factors.Methods Using the prospective longitudinal study method,a total of 447 patients with breast cancer who received treatment from November 2022 to March 2023 at 4 tertiary hospitals which were Shanghai Cancer Center Affiliated to Fudan University,the First Affiliated Hospital of China Medical University,Xijing Hospital of the Air Force Medical University,and Union Hospital of Tongji Medical College of Huazhong University of Science and Technology was selected by convenience sampling,and were conducted the follow-up investigation using various instruments including a general demographic questionnaire,the comprehensive scores for financial toxicity based on the patient-reported outcome measures,the BCPT eight symptom scale,memorial symptom assessment scale-short form-psychological symptom subscale score,the mararthur scale of subjective social status,perceived social support scale,and the 10-item connor-davidson resilience scale at 1 week,3 months,6 months,and 1 year post-operation.Results A total of 378 patients completed all 4 follow-up surveys,resulting in an effective response rate of 84.56%.Financial toxicity scores of participants at 4 time points were(23.47±10.53)points,(22.74±11.37)points,(24.01±10.57)points,and(24.24±10.49)points,respectively.The results of generalized estimating equation analysis indicated that the factors influencing financial toxicity level included type of residence,disposable family savings,commercial insurance status,average monthly family income,number of treatments received,subjective socioeconomic status,social support,psychological resilience,and symptom burden(P<0.05).Conclusion Financial toxicity among postoperative patients with breast cancer exhibits a dynamic trend of initial aggravation followed by gradual alleviation,influenced by socio-demographic factors,disease and treatment-related factors,and psychological

关 键 词：乳腺癌 经济毒性 影响因素 纵向研究 

分 类 号：R473.73[医药卫生—护理学]