Identification of subgroups of self-reported outcomes among breast cancer patients undergoing surgery and chemotherapy:A crosssectional study  

接受手术和化疗的乳腺癌患者自我报告结局的潜在类别分析

作　　者：Feixia Ni Tingting Cai Tingting Zhou Changrong Yuan 倪飞霞;蔡婷婷;周婷婷;袁长蓉

机构地区：[1]Department of Pediatric Hematology/Oncology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China [2]School of Nursing,Fudan University,Shanghai,China

出　　处：《International Journal of Nursing Sciences》2025年第1期51-58,I0003,共9页国际护理科学(英文)

基　　金：supported by the Hospital-level Nursing Research Project of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(xhhlcx2023-017);the third period of the 14th Five-Year nursing talent project of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine(Xhlxm014);the Ministry of Education of Humanities and Social Science Project(23YJC630002)and High-level local university construction project founded by Shanghai Municipal Education Commission.

摘　　要：Objectives:To identify the subgroups of self-reported outcomes and associated factors among breast cancer patients undergoing surgery and chemotherapy.Methods:A cross-sectional study was conducted between January and November 2021.We recruited patients from two tertiary hospitals in Shanghai,China,using convenience sampling during their hospitalization.Patients were assessed using a questionnaire that included sociodemographic and clinical characteristics,the Patient Reported Outcomes Measurement Information System profile-29(PROMIS-29),and the PROMIS-cognitive function short form 4a.Latent class analysis was performed to examine possible classes regarding self-reported outcomes.Multiple logistic regression analysis was used to determine the associated factors.Analysis of variance(ANOVA)was conducted for symptoms across the different classes.Results:A total of 640 patients participated in this study.The findings revealed three subgroups in terms of self-reported outcomes among breast cancer patients undergoing surgery and chemotherapy:low physical-social-cognitive function,high physical-low cognitive function,and high physical-socialcognitive function.Multivariable logistic regression analysis showed that age(≥60 years old),menopause,the third chemotherapy cycle,undergoing simple mastectomy and breast reconstruction,duration of disease 3-12 months,stageⅢ/Ⅳcancer,and severe pain were associated factors of the functional decline groups.Besides,significant differences in depression and sleep disorders were observed among the three groups.Conclusions:Breast cancer patients receiving surgery and chemotherapy can be divided into three subgroups.Aging,menopause,chemotherapy cycle,surgery type,duration and stage of disease,and severe pain affected the functional decline groups.Consequently,healthcare professionals should make tailored interventions to address the specific functional rehabilitation and symptom relief needs.目的明确接受手术和化疗的乳腺癌患者自我报告结局的潜在类别,并分析其影响因素。方法采用便利抽样法,于2021年1月至11月选取上海市2所三级甲等医院接受手术和化疗的乳腺癌住院患者为研究对象。使用社会人口学与临床资料调查表、中文版患者报告的结局测量信息系统和认知功能简表收集相关数据。采用潜在类别分析以明确乳腺癌患者自我报告结局的潜在类别,并通过多元logistic回归分析探讨不同类别的影响因素。结果共纳入640例患者。潜在类别分析结果显示接受手术和化疗的乳腺癌患者可分为3个潜在类别:身体-社会-认知功能低发组、高身体-低认知功能组和身体-社会-认知功能高发组。多元logistic回归分析显示,与身体-社会-认知功能高发组相比,身体-社会-认知功能低发组更可能为年长、绝经后、第三个化疗周期、接受单纯乳房切除术与乳房重建术以及3-12个月病程的患者;高身体-低认知功能组更可能为疾病为Ⅲ/Ⅳ期、接受单纯乳房切除术与乳房重建术、病程为3-12个月以及严重疼痛的患者。结论临床医护人员应重点关注身体-社会-认知功能低发组和高身体-低认知功能组,及时识别高风险人群,根据不同类别的特点,采取相应干预措施以满足患者特定的功能康复与症状缓解需求。

关 键 词：Breast neoplasms Latent class analysis Function SURGERY CHEMOTHERAPY 

分 类 号：R473.73[医药卫生—护理学]