直肠癌保肛术后患者症状群及其影响因素分析  

Symptom clusters and influencing factors in patients undergoing sphincter-preserving surgery for rectal cancer

作　　者：杨亚楠 于淼[3] 汪铭暄 陈泓伯 李葆华[3] Yang Yanan;Yu Miao;Wang Mingxuan;Chen Hongbo;Li Baohua(Department of Oncology,Shanxi Provincial People's Hospital,Taiyuan 030012,China;School of Nursing,Peking University,Beijing 100191,China;Department of Nursing,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]山西省人民医院肿瘤科,太原030012 [2]北京大学护理学院,北京100191 [3]北京大学第三医院护理部,北京100191

出　　处：《中华现代护理杂志》2024年第34期4654-4661,共8页Chinese Journal of Modern Nursing

摘　　要：目的调查直肠癌保肛术后患者症状群的种类和数量并探索症状群的影响因素。方法采用便利抽样法,选取于2021年1月—2023年1月曾在北京大学第三医院普外科接受直肠癌保肛术的患者192例为研究对象。采用一般资料调查表、直肠癌保肛术后患者症状发生情况问卷、国际体力活动问卷短卷对患者进行调查。结果本研究共发放问卷192份,回收有效问卷159份。对发生率>10.0%的18项症状进行探索性因子分析,得出精神相关症状群、排便增多相关症状群、疲乏-疼痛症状群、睡眠障碍症状群、便秘相关症状群为直肠癌保肛术后患者的主要症状群。Logistic回归分析结果显示,术后时间是精神相关症状群的影响因素(P<0.05),术前放疗和术后时间是排便增多相关症状群的影响因素(P<0.05),术后化疗是疲劳-疼痛症状群的影响因素(P<0.05),每周静坐时间是睡眠障碍相关症状群的影响因素(P<0.05)。结论直肠癌保肛术后患者存在多个症状群,术前放疗、久坐会增加症状群的发生风险,术后不同时间段与不同症状群的发生风险相关,未发现体力活动水平对症状群有影响。医护人员应根据症状群和影响因素给予针对性的干预,减少患者症状的发生。ObjectiveTo investigate the types and number of symptom clusters in patients undergoing sphincter-preserving surgery for rectal cancer and explore the influencing factors of these symptom clusters.MethodsTotally 192 patients who underwent sphincter-preserving surgery for rectal cancer in the Department of General Surgery at Peking University Third Hospital between January 2021 and January 2023 were selected by convenience sampling.A general information questionnaire,Post-sphincter-preserving Surgery Symptom Questionnaire,and the International Physical Activity Questionnaire-Short Form(IPAQ-SF)were used for data collection.ResultsA total of 192 questionnaires were distributed,with 159 valid questionnaires returned.Exploratory factor analysis on 18 symptoms with an incidence rate of over 10.0%identified five primary symptom clusters:the psychological symptom cluster,increased defecation cluster,fatigue-pain cluster,sleep disturbance cluster,and constipation-related cluster.Logistic regression analysis showed that postoperative duration was an influencing factor for the psychological symptom cluster(P<0.05);preoperative radiotherapy and postoperative duration were influencing factors for the increased defecation cluster(P<0.05);postoperative chemotherapy was an influencing factor for the fatigue-pain cluster(P<0.05);and weekly sedentary time was an influencing factor for the sleep disturbance cluster(P<0.05).ConclusionsPatients undergoing sphincter-preserving surgery for rectal cancer experience multiple symptom clusters.Preoperative radiotherapy and prolonged sedentary behavior increase the risk of symptom clusters,and different postoperative periods are associated with varying risks for different symptom clusters.However,physical activity levels do not appear to influence the occurrence of symptom clusters.Healthcare providers should implement targeted interventions based on the symptom clusters and their influencing factors to reduce the incidence of symptoms in patients.

关 键 词：直肠癌 保肛术 症状群 体力活动 

分 类 号：R473.73[医药卫生—护理学]