鼻咽癌患者诱导化疗序贯同期放化疗期间躯体-心理症状负担轨迹及影响因素研究  

Physical-psychological symptom burden trajectories and influencing factors in nasopharyngeal carcinoma patients during induction chemotherapy plus concurrent chemoradiotherapy

作　　者：刘琪 刘佳丽 刘玉[2] 杨丽敏 范育英[3] 吕星[3] 覃惠英[2] LIU Qi;LIU Jia-li;LIU Yu;YANG Li-min;FAN Yu-ying;LV Xing;JIN Hui-ying(School of Nursing,Sun Yat-sen University,Guangzhou 510060,China;Dept.of Nursing Administration,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Dept.of Nasopharyngeal Carcinoma,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Dept.of Nursing Administration,Affiliated Hospital of Guizhou Medical University,Guiyang 561113,China)

机构地区：[1]中山大学护理学院,广东广州510060 [2]中山大学肿瘤防治中心护理部,广东广州510060 [3]中山大学肿瘤防治中心鼻咽科,广东广州510060 [4]贵州医科大学附属医院护理部,贵州贵阳561113

出　　处：《护理学报》2025年第1期1-6,共6页Journal of Nursing(China)

基　　金：国家自然科学基金面上项目(82172863);广东省医学科学技术研究基金(A2022020)。

摘　　要：目的调查鼻咽癌患者诱导化疗序贯同期放化疗期间躯体、心理症状负担轨迹及影响因素。方法便利选取广州某三级甲等医院行诱导化疗序贯同期放化疗的212例鼻咽癌患者为研究对象,于诱导化疗期、放疗第5次、放疗第10次、放疗第15次、放疗第20次、放疗第25次、放疗结束、放疗结束后1个月末收集患者报告的不良事件通用术语标准。采用潜类别增长模型分析躯体、心理症状负担轨迹及潜在类别。结果躯体症状负担识别为高躯体症状负担组(89.2%)、中高躯体症状负担组(10.8%);心理症状负担识别为中高心理症状负担组(22.7%)、低心理症状负担组(47.6%)、无心理症状负担组(29.7%)。高躯体症状负担组和中高心理症状负担组在诱导化疗期的症状负担均高于其他组(P<0.05)。logistic回归分析显示,年龄、是否合并其他慢性病、信息获取能力是躯体症状负担轨迹的影响因素;意义感、信息获取能力是心理症状负担轨迹的影响因素(P<0.05)。结论鼻咽癌患者治疗期间的躯体、心理症状负担轨迹存在异质性。年龄低、合并其他慢性病、低信息获取能力的鼻咽癌患者更可能属于高躯体症状负担组;低意义感、低信息获取能力的患者更可能属于症状负担更高的心理症状负担组。Objective To identify physical-psychological symptom burden trajectories and influencing factors of nasopharyngeal carcinoma patients during induction chemotherapy(IC)plus concurrent chemoradiotherapy(CCRT).Methods Nasopharyngeal carcinoma patients who received IC plus CCRT(n=212)in a tertiary grade-A hospital of Guangzhou were selected as research subjects.The Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events were collected during IC,at the 5th,10th,15th,20th,and 25th radiotherapy,at the end of radiotherapy,and one month after radiotherapy.Latent class growth modeling was applied to analyze the trajectoy categories of physical and psychological symptom burden.Results Two physical symptom burden trajectories were identified,labeling“high physical symptom burden group”(89.2%)and“moderate-high physical symptom burden group”(10.8%).Three psychological symptom burden trajectories were identified as“moderate-high psychological symptom burden group”(22.7%),“low psychological symptom burden group”(47.6%),and“no psychological symptom burden group”(29.7%).The symptom burden of the high physical symptom burden group and the medium-high psychological symptom burden group was higher than that of the other groups during IC(P<0.05).Logistic regression analysis showed that age,the presence or absence of other chronic diseases and information acquisition ability were the influencing factors of physical symptom burden trajectories,while information acquisition ability and sense of meaning were the influencing factors of the psychological symptom burden trajectories(P<0.05).Conclusion There is heterogeneity in the trajectories of physical and psychological symptom burden during treatment.Younger patients,and those with other chronic diseases or poor information acquisition ability are more likely to have a sustained high physical symptom burden.Patients with poor information acquisition ability or lower sense of meaning are more likely to have a sustained higher psychologic

关 键 词：鼻咽癌 诱导化疗序贯同期放化疗 症状负担轨迹 潜类别增长模型 健康素养 心理一致感 

分 类 号：R473.73[医药卫生—护理学]