Cho Myung Sook, Kwon In Gak, Kim Hee Sun, Kim Kyunghee, Ryu Eunjung
Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Acad Nurs. 2009 Oct;39(5):683-92. doi: 10.4040/jkan.2009.39.5.683.
The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma.
This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters.
Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression.
Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.
本研究旨在识别与癌症相关的症状群，并验证肝细胞癌患者中所揭示症状群的概念意义。
本研究为横断面调查和方法学研究。从首尔的一家医疗中心招募了194例肝细胞癌患者。使用20项症状清单评估患者的症状严重程度。对选定的症状采用主成分分析法并进行方差最大旋转。为验证所揭示的症状群，通过患者的体能状态、Child-Pugh分级和症状群之间的情绪状态分析统计差异。
疲劳是最常见的症状（97.4%），其次是精力不足和胃部不适。患者的症状严重程度评分符合一个四因素模型，该模型解释了61.04%的方差。这四个因素分别被命名为疼痛-食欲群、疲劳群、瘙痒-便秘群和胃肠道群。所揭示的症状群在患者体能状态（ECOG-PSR）、Child-Pugh分级、焦虑和抑郁方面存在显著差异。
了解这些症状群可能有助于护士理解症状聚集的合理机制。对疾病相关和治疗相关症状进行有效的症状管理对于促进肝细胞癌患者的身体和情绪状态至关重要。
