Hoekstra Johanna, de Vos Rien, van Duijn Nico P, Schadé Egbert, Bindels Patrick J E
Departments of General Practice, Division of Clinical Methods & Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
J Pain Symptom Manage. 2006 Jan;31(1):22-30. doi: 10.1016/j.jpainsymman.2005.06.014.
This randomized controlled trial investigated the effect of reporting physical symptoms by using a systematic symptom monitoring instrument, the Symptom Monitor, on symptom prevalence and severity among patients with cancer in the palliative phase. The overall objective was to achieve symptom relief through systematic and regular symptom reporting by patients themselves. One hundred forty-six patients with cancer in the palliative phase were randomized to either the intervention group (n = 69 with Symptom Monitor) or the control group (n = 77 without Symptom Monitor). Ten physical symptoms with regard to prevalence and severity were monitored. After 2 months, the prevalence of symptoms was lower in the intervention group compared to the control group (prevalent differences 2.1-24.3%) for 9 out of 10 symptoms (except coughing). The intervention group scored a statistically significantly lower prevalence in constipation and vomiting (prevalence differences 24.3% and 18.0%, respectively). In four symptoms (fatigue, lack of appetite, shortness of breath, and nausea), the intervention group had a lower, although not statistically significant, severity score (median differences 0.5-1). In four symptoms (pain, coughing, sleeplessness, and diarrhea), the severity score was the same in both groups (medians 2-4). In two symptoms (constipation and vomiting), the severity score was lower in the control group (median differences -1 and -2). A comparison between the study groups on improved, deteriorated, or steady-state cases showed that the severity score had deteriorated less for 8 out of 10 symptoms in a larger proportion of patients in the intervention group. Although statistical significance was not reached, the prevalence as well as severity of symptoms in the palliative phase of cancer can be influenced by using the Symptom Monitor.
这项随机对照试验研究了使用一种系统症状监测工具“症状监测仪”报告身体症状对姑息治疗阶段癌症患者症状发生率和严重程度的影响。总体目标是通过患者自身系统且定期地报告症状来实现症状缓解。146名处于姑息治疗阶段的癌症患者被随机分为干预组（n = 69，使用症状监测仪）和对照组（n = 77，未使用症状监测仪）。监测了10种身体症状的发生率和严重程度。2个月后，干预组中10种症状中的9种（咳嗽除外）的症状发生率低于对照组（发生率差异为2.1% - 24.3%）。干预组便秘和呕吐的发生率在统计学上显著较低（发生率差异分别为24.3%和18.0%）。在4种症状（疲劳、食欲不振、呼吸急促和恶心）中，干预组的严重程度得分较低，尽管无统计学意义（中位数差异为0.5 - 1）。在4种症状（疼痛、咳嗽、失眠和腹泻）中，两组的严重程度得分相同（中位数为2 - 4）。在2种症状（便秘和呕吐）中，对照组的严重程度得分较低（中位数差异为 -1和 -2）。对研究组中症状改善、恶化或稳定的病例进行比较显示，干预组中较大比例的患者在10种症状中的8种症状的严重程度得分恶化程度较小。尽管未达到统计学意义，但使用症状监测仪可影响癌症姑息治疗阶段症状的发生率和严重程度。
