宫颈癌放疗病人症状困扰的变化轨迹及核心影响因素  

Analysis of changing trajectory and core influencing factors of symptom disturbance in patients with cervical cancer radiotherapy

作　　者：陈国萍 窦启金 武雅琴[2] CHEN Guoping;DOU Qijin;WU Yaqin(The Affiliated Taizhou People's Hospital of Nanjing Medical University,Jiangsu 225300 China;Jiangsu Cancer Hospital)

机构地区：[1]南京医科大学附属泰州人民医院,江苏225300 [2]江苏省肿瘤医院

出　　处：《护理研究》2024年第23期4137-4144,共8页Chinese Nursing Research

基　　金：2021年度江苏省妇幼健康科研项目,编号:F202165。

摘　　要：目的:探讨宫颈癌放疗病人症状困扰的变化轨迹及核心影响因素决策树分析。方法:采用便利抽样法,选择2020年1月—2022年12月在我院接受放疗的260例宫颈癌病人为研究对象,采用一般资料调查表、罗德适应症状困扰量表、疾病进展恐惧简化量表、社会支持评定量表、身体意象量表对病人进行基线调查,并分别于病人放疗前、放疗结束时、放疗结束后3个月和放疗结束后6个月调查病人的症状困扰水平,采用潜变量增长模型识别症状困扰轨迹类别,最后通过决策树分析症状困扰轨迹类别的核心影响因素。结果:宫颈癌放疗病人放疗前、放疗结束时、放疗结束后3个月和放疗结束后6个月的罗德适应症状困扰量表得分依次为(68.14±14.57)分、(62.54±11.36)分、(71.52±16.32)分、(75.35±18.58)分。宫颈癌放疗病人症状困扰评分变化趋势识别出中症状困扰组(83.85%)和高症状困扰组(16.15%)2条症状困扰轨迹。决策树模型显示,文化程度、职业状态、癌因性疲乏、毒副反应程度、疾病进展恐惧简化量表得分、社会支持评定量表得分、身体意象量表得分均可预测宫颈癌放疗病人症状困扰变化轨迹类别,其中毒副反应程度是症状困扰变化轨迹类别最为重要的预测因素。结论:宫颈癌放疗病人在放疗前至放疗结束后6个月的症状困扰轨迹分为中症状困扰和高症状困扰2种趋势。临床可根据文化程度、职业状态、癌因性疲乏、毒副反应程度、疾病进展恐惧简化量表得分、社会支持评定量表得分、身体意象量表得分因素识别可能进展为高症状困扰组的高危病人,并根据决策树的预测变量重要性排序制定以毒副反应程度、身体意象量表得分等变量为主的干预方案,以改善宫颈癌放疗病人的症状困扰水平。Objective:To explore the change trajectory of symptoms and distress in patients with cervical cancer radiotherapy and analyze the decision tree of core influencing factors.Methods:A total of 260 patients with cervical cancer who received radiotherapy in our hospital from January 2020 to December 2022 were selected by convenience sampling method.Baseline investigation was conducted by General Data Questionnaire,Rhodes Adaptive Symptom Distress Scale,Simplified Fear of Disease Progression Scale,Social Support Rating Scale and Body Image Scale.Symptom distress levels of patients were investigated before,after,3 months after and 6 months after radiotherapy,and latent variable growth model was used to identify symptom distress trajectory categories.Finally,core influencing factors of symptom distress trajectory categories were analyzed by decision tree.Results:Rhodes Adaptive Symptom Distress Scale scores were 68.14±14.57,62.54±11.36,71.52±16.32,75.35±18.58 before,after,3 months after and 6 months after radiotherapy.The change trend of symptom distress score of cervical cancer radiotherapy patients identified two symptom distress tracks in moderate symptom distress group(83.85%)and high symptom distress group(16.15%).Decision tree model showed that education level,occupational status,cancer fatigue,toxicity,Simplified Fear of Disease Progression Scale score,Social Support Rating Scale score and Body Image Scale score could all predict the trajectory of symptom distress of cervical cancer radiotherapy patients,and toxicity was the most important predictor of symptom distress trajectory category.Conclusion:The symptoms of cervical cancer patients from before radiotherapy to 6 months after radiotherapy were divided into moderate symptoms and high symptoms.Clinically,high-risk patients who may progress into the high symptom distress group can be identified according to the education level,occupational status,cancer fatigue,toxicity,Simplified Fear of Disease Progression Scale score,Social Support Rating Scale score an

关 键 词：宫颈癌 放疗 症状困扰 变化轨迹 影响因素 决策树 

分 类 号：R473.73[医药卫生—护理学]