Donovan Heidi Scharf, Hartenbach Ellen M, Method Michael W
Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA.
Gynecol Oncol. 2005 Nov;99(2):404-11. doi: 10.1016/j.ygyno.2005.06.062. Epub 2005 Aug 19.
Optimal cancer symptom management requires effective patient-health care provider (HCP) communication. The goals of this study were to 1) describe symptom experiences of women with ovarian cancer, 2) evaluate frequency of patient-HCP communication about symptoms, and 3) evaluate whether communication is associated with patients' confidence in managing symptoms.
This was a cross-sectional mailed survey study. The Symptom Experience Survey, containing valid, reliable measures of symptom severity and controllability; symptom communication; and symptom-related coping strategies, was mailed to members of the National Ovarian Cancer Coalition. Descriptive statistics, t tests, correlations, and ANCOVA were used to address study objectives.
This analysis focuses on the 279 respondents who had active disease. The majority of women had recurrent disease (96%) and were on chemotherapy (57%). Women reported a mean of 12 concurrent symptoms. Fatigue, bowel disturbances, and peripheral neuropathies were the most severe and most noticed symptoms. Only 61% of women had discussed their most noticed symptom with an HCP in the past month, and only 50% of women reported that they had received symptom management recommendations. Women reported low levels of perceived control over symptoms (M = 1.97 on a 0-4 scale). There was a significant interaction effect for symptom discussions and management recommendations on perceived control. Women who had never received recommendations had low perceived control whether or not they had discussed their symptom with an HCP in the past month. For women who had received recommendations, those who had discussed their symptom with an HCP in the past month had higher perceived control compared to those who had not discussed their symptom.
Women with ovarian cancer experience multiple symptoms, but many do not discuss symptoms with their HCPs and fewer report receiving symptom management recommendations. Women would benefit from more active symptom assessment and discussion of management strategies by HCPs.
优化癌症症状管理需要患者与医护人员（HCP）进行有效的沟通。本研究的目的是：1）描述卵巢癌女性的症状体验；2）评估患者与医护人员就症状进行沟通的频率；3）评估沟通是否与患者管理症状的信心相关。
这是一项横断面邮寄调查研究。将包含症状严重程度和可控性的有效、可靠测量指标、症状沟通以及症状相关应对策略的症状体验调查问卷邮寄给国家卵巢癌联盟的成员。使用描述性统计、t检验、相关性分析和协方差分析来实现研究目标。
本分析聚焦于279名患有活动性疾病的受访者。大多数女性患有复发性疾病（96%）且正在接受化疗（57%）。女性报告平均同时出现12种症状。疲劳、肠道功能紊乱和周围神经病变是最严重且最常被注意到的症状。在过去一个月中，只有61%的女性与医护人员讨论过她们最常注意到的症状，只有50%的女性报告称她们收到了症状管理建议。女性报告对症状的感知控制水平较低（在0至4的量表上，M = 1.97）。症状讨论和管理建议对感知控制有显著的交互作用。从未收到建议的女性，无论过去一个月是否与医护人员讨论过症状，其感知控制水平都较低。对于收到建议的女性，过去一个月与医护人员讨论过症状的女性比未讨论过症状的女性有更高的感知控制水平。
卵巢癌女性经历多种症状，但许多人未与医护人员讨论症状，更少有人报告收到症状管理建议。医护人员更积极地进行症状评估并讨论管理策略将使女性受益。
