Institute of Nursing Science, University of Basel, Switzerland.
Swiss Med Wkly. 2011 Nov 8;141:w13303. doi: 10.4414/smw.2011.13303. eCollection 2011.
Prevalence of symptoms, with a focus on fatigue, and changes of symptoms were explored over three months in outpatients with lymphoma, lung, breast or colorectal cancer, receiving chemotherapy in the oncology outpatient clinic of a Swiss tertiary care hospital.
Prospective, descriptive design; symptom prevalence was measured at start of chemotherapy (T1), and one week prior to the third and fourth cycle (T2, T3). Included were patients starting chemotherapy, with expected survival of >3 months, irrespective of stage of disease. The Memorial Symptom Assessment Scale was used to assess 32 symptoms; fatigue was measured with the FACIT-Fatigue Scale (negative scale). Data were analysed using descriptive statistics and random-intercept regression models.
77 patients participated at T1, 58 and 50 at T2 and T3. Patients experienced on average 9.8, 14.4, and 13.7 symptoms, showing a significant increase over time. Lack of energy and feeling drowsy were most frequent. Symptom scores for lack of energy, changes in skin, pain, and feeling drowsy remained >2 over time (scale 0-4, higher scores = more symptoms). Fatigue mean scores were 36.3, 30.2, and 31.3, showing a significant increase of fatigue over time. Individual symptom trajectories varied widely within and among patients.
High symptom prevalence at start of chemotherapy as well as over time and great variability in symptom experience call for an individual, systematic symptom assessment and management that does not focus solely on side-effects of therapy but includes disease-related symptoms to achieve satisfactory control of symptoms in outpatients receiving chemotherapy.
在瑞士三级保健医院的肿瘤门诊接受化疗的淋巴瘤、肺癌、乳腺癌或结直肠癌门诊患者中，研究了三个月内的症状流行情况，重点是疲劳，以及症状的变化。
前瞻性描述性设计；在化疗开始时（T1），以及第三和第四个周期前一周（T2、T3）测量症状的流行率。包括开始化疗、预期生存时间>3 个月、无论疾病分期如何的患者。使用 Memorial 症状评估量表评估 32 种症状；使用 FACIT-Fatigue 量表（负量表）测量疲劳。使用描述性统计和随机截距回归模型分析数据。
77 名患者在 T1 时参与，58 名和 50 名在 T2 和 T3 时参与。患者平均经历 9.8、14.4 和 13.7 种症状，随时间呈显著增加。缺乏能量和昏昏欲睡的感觉最为常见。随时间推移，缺乏能量、皮肤变化、疼痛和昏昏欲睡的症状评分一直>2（量表 0-4，得分越高，症状越多）。疲劳平均得分为 36.3、30.2 和 31.3，随时间推移，疲劳呈显著增加。个体症状轨迹在患者内和患者间差异很大。
化疗开始时以及随时间推移的高症状流行率以及症状体验的巨大变异性，需要进行个体化、系统的症状评估和管理，不仅要关注治疗的副作用，还要包括与疾病相关的症状，以实现接受化疗的门诊患者症状的满意控制。
