Liu Shan, Ercolano Elizabeth, Siefert Mary Lou, McCorkle Ruth
Department of Nursing, School of Medicine, Jinan University, Guangzhou, China.
Oncol Nurs Forum. 2010 Mar;37(2):E133-40. doi: 10.1188/10.ONF.E133-E140.
PURPOSE/OBJECTIVES: To explore patterns of symptoms over time and the relationships between selected demographic and clinical characteristics.
Secondary analysis of longitudinal data.
A hospital and comprehensive cancer center in the northeastern United States.
66 women with gynecologic cancers, postsurgical, and scheduled to receive chemotherapy.
A secondary analysis using descriptive and general estimating equation statistical procedures was conducted on symptom and disease data in a subset of a larger nursing intervention study.
Demographic and clinical variables including cancer site, new diagnosis or recurrence, stage, treatment, comorbidities, emotional distress, use of a symptom management tool kit, and 10 symptoms over time.
Two patterns of symptoms were identified. The first pattern (pain, bowel dysfunction, disturbed sleep, depression, nausea, and lack of appetite) decreased, and the second pattern (fatigue, anxiety, hair loss, and numbness) remained constant over time. The total number of symptoms decreased over time. Factors associated with symptoms, such as the use of a tool kit and emotional distress, were identified.
Tool kit use by women who experienced fatigue, bowel dysfunction, and anxiety suggests its usefulness as a self-care guide. Explanations for the two patterns of symptoms are discussed.
Postsurgical management should include management and monitoring of symptoms associated with treatment. Screening for emotional distress is recommended in this population. Use of the tool kit could be an effective postsurgical management strategy for women with gynecologic cancers.
目的/目标：探讨症状随时间变化的模式以及选定的人口统计学和临床特征之间的关系。
对纵向数据进行二次分析。
美国东北部的一家医院及综合癌症中心。
66名妇科癌症术后且计划接受化疗的女性。
在一项更大规模的护理干预研究的子集中，对症状和疾病数据进行二次分析，采用描述性和广义估计方程统计程序。
人口统计学和临床变量，包括癌症部位、新诊断或复发、分期、治疗、合并症、情绪困扰、症状管理工具包的使用情况，以及随时间变化的10种症状。
识别出两种症状模式。第一种模式（疼痛、肠道功能障碍、睡眠障碍、抑郁、恶心和食欲不振）随时间减少，第二种模式（疲劳、焦虑、脱发和麻木）随时间保持不变。症状总数随时间减少。确定了与症状相关的因素，如工具包的使用和情绪困扰。
经历疲劳、肠道功能障碍和焦虑的女性使用工具包表明其作为自我护理指南的有用性。讨论了两种症状模式的解释。
术后管理应包括对与治疗相关症状的管理和监测。建议对该人群进行情绪困扰筛查。使用工具包可能是妇科癌症女性有效的术后管理策略。
