Johansson Eva, Wilson Barbara, Brunton Lisa, Tishelman Carol, Molassiotis Alex
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Oncol Nurs Forum. 2010 Mar;37(2):E105-13. doi: 10.1188/10.ONF.E105-E113.
PURPOSE/OBJECTIVES: To explore occurrence of symptoms and relationships between them as perceived by patients with lymphoma before, during, and 14 months after the beginning of treatment.
Qualitative and longitudinal.
A major oncology center in the United Kingdom.
10 adult patients with lymphoma (3 women and 7 men) were recruited at treatment initiation.
Semistructured audiotaped interviews were conducted with participants in median 15 days, 4 months, and 14 months after diagnosis. Analysis of the verbatim transcripts was inspired by interpretive description, which is a grounded approach articulating patterns emerging in relation to clinical phenomena.
Symptoms.
Symptoms commonly reported by patients in this sample were lack of energy, lymphadenopathy, weight loss, itching, pain, sadness, night sweats, sleeping difficulties, and hair loss. Co-occurring prediagnosis symptoms seem to have led patients to seek medical attention; co-occurring symptoms during treatment seem to have a cumulatively distressing effect. Several of the symptoms were described as interrelated, with one symptom leading to one or more other symptoms.
The data confirm a complex symptomatology in patients with lymphoma. In addition, the findings support that co-occurring symptoms may have a synergistic effect on patients' health outcomes and add new knowledge about relationships between symptoms from patients' perspectives.
Illustrating symptoms and interrelationships between symptoms using diagrams may be useful to support communication as well as in identifying targets for symptom management.
目的/目标:探讨淋巴瘤患者在治疗开始前、治疗期间及治疗开始后14个月所感知到的症状发生情况及其相互关系。
定性且纵向研究。
英国一家大型肿瘤中心。
10名成年淋巴瘤患者(3名女性和7名男性)在治疗开始时被招募。
在诊断后的中位数15天、4个月和14个月对参与者进行半结构化录音访谈。对逐字记录的分析受到解释性描述的启发,这是一种基于临床现象中出现的模式进行阐述的扎根方法。
症状。
该样本中患者普遍报告的症状有精力不足、淋巴结病、体重减轻、瘙痒、疼痛、悲伤、盗汗、睡眠困难和脱发。诊断前同时出现的症状似乎促使患者寻求医疗关注;治疗期间同时出现的症状似乎具有累积性的困扰作用。其中一些症状被描述为相互关联,一种症状会导致一种或多种其他症状。
数据证实淋巴瘤患者存在复杂的症状表现。此外,研究结果支持同时出现的症状可能对患者的健康结果产生协同作用,并从患者角度增加了关于症状之间关系的新知识。
用图表说明症状及其相互关系可能有助于支持沟通以及确定症状管理的目标。