中青年宫颈癌术后患者化疗期间症状群与生命质量的纵向研究  

Longitudinal study of symptom cluster and quality of life in young and middle-aged postoperative patients with cervical cancer during chemotherapy

作　　者：胡媛 张红梅 李金凤 张慧娟 张慧萌 Hu Yuan;Zhang Hongmei;Li Jinfeng;Zhang Huijuan;Zhang Huimeng(Department of Gynecology,Henan Provincial People′s Hospital,People′s Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院,郑州大学人民医院妇科,郑州450000

出　　处：《中国实用护理杂志》2024年第32期2503-2512,共10页Chinese Journal of Practical Nursing

摘　　要：目的探讨中青年宫颈癌术后患者在化疗期间症状群与生命质量纵向变化规律,分析两者之间的相关性,以期为临床医护人员症状管理及改善患者生命质量提供参考。方法采用纵向研究方法,便利抽样法选择2022年12月至2023年8月于河南省人民医院妇科病房行宫颈癌根治术后化疗的中青年患者252例为研究对象。在患者化疗前2 d(T1)、第1次化疗后1周内(T2)、第3次化疗后1周内(T3)、第6次化疗后1周内(T4),采用一般资料调查表、中文版记忆症状评估量表及宫颈癌生命质量评价量表收集资料,对资料采用探索性因子分析提取症状群,运用广义估计方程模型分析症状群与生命质量动态变化趋势及相关性。结果最终纳入221例宫颈癌患者,年龄18~59(46.85±6.50)岁。T1、T2时,患者存在4个症状群,分别是心理症状群、胃肠道症状群、疾病行为症状群、围绝经期症状群;T3和T4时增加了神经系统症状群和自我形象紊乱症状群,共6个症状群。各症状群得分越高,其生命质量总分越低(Waldχ^(2)值为8.08~62.70,均P<0.01)。结论中青年宫颈癌术后患者在化疗过程中遭受多个症状群,不仅保持相对稳定的状况,而且呈现出不断变化的趋势。对化疗期间中青年宫颈癌术后患者症状群进行有效的动态管理,有望改善其生命质量。ObjectiveTo explore the longitudinal changes of symptom clusters and quality of life in young and middle-aged postoperative patients with cervical cancer during chemotherapy,and to clarify the correlation between the two,in order to provide reference for clinical staff symptom management and improvement of patients′quality of life.MethodsA longitudinal study was conducted,a total of 252 young and middle-aged who underwent chemotherapy after radical cervical cancer surgery in the gynecological ward of Henan Provincial People′s Hospital from December 2022 to August 2023 were selected as the investigation objects by convenient sampling method.Data were collected at 2 d before chemotherapy(T1),1 week after the first chemotherapy(T2),1 week after the third chemotherapy(T3),and 1 week after the sixth chemotherapy(T4),using the general data questionnaire,the Chinese version of the Memorial Symptom Assessment Scale and the Functional Assessment of Cancer Therapy-Cervix.Exploratory factor analysis was used to extract symptom clusters from the data.The generalized estimation equation model was used to analyze the dynamic change trend and correlation between symptom clusters and quality of life.ResultsA total of 221 patients with cervical cancer aged 18-59(46.85±6.50)years old were included.At T1 and T2,there were 4 symptom clusters,which were psychological symptom cluster,gastrointestinal symptom cluster,disease behavior symptom cluster and perimenopausal symptom cluster.T3 and T4 increased the neurological symptom cluster and self-image disorder symptom cluster,a total of 6 symptom clusters.The higher score of each symptom cluster,the lower total score of quality of life(Waldχ^(2) values were 8.08-62.70,all P<0.01).ConclusionsYoung and middle-aged postoperative patients with cervical cancer suffered from multiple symptom clusters during chemotherapy,which not only remained relatively stable,but also showed a constantly changing trend.Effective dynamic management of symptoms clusters in young and middle-aged postoper

关 键 词：宫颈肿瘤 中青年 化疗 症状群 生命质量 纵向研究 

分 类 号：R473.73[医药卫生—护理学]