Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
Psychooncology. 2013 Jun;22(6):1220-8. doi: 10.1002/pon.3126. Epub 2012 Jun 25.
This study aimed to examine changes in physical symptom severity, functional status, supportive care needs, and related factors in oral cavity cancer patients during 6 months after beginning radiation therapy (RT) or concurrent chemotherapy and radiation therapy (CCRT).
A prospective longitudinal study was conducted involving oral cavity cancer patients from an RT clinic at a medical center in northern Taiwan. Patients were assessed for supportive care needs and physical symptoms at five time points: before the beginning of RT or CCRT and at 1, 2, 3, and 6 months after beginning RT or CCRT. The generalized estimating equation was used to identify predictors of overall needs as well as six specific dimensions of needs.
A total of 82 patients completed the 6 months of follow-up. Patients had moderate to high levels of supportive care needs over the 6 months. Although the highest information need was at the pretreatment phase, in general, the peak for overall and individual care needs was at 2 months since first receiving RT or CCRT. Patients without religious beliefs as well as those with higher educational level, functional level, overall physical symptom severity, and baseline anxiety reported more supportive care needs. Anxiety level before treatment was the most common factor across most supportive care needs. Individual physical symptoms, including fatigue, swallowing difficulty, and oral mucositis, were significantly related to higher physical and daily living needs.
A systematic clinical assessment to detect patients' care needs is necessary to improve the provision of timely cancer care and meet patients' healthcare needs.
本研究旨在探讨口腔癌患者在接受放射治疗(RT)或同期放化疗(CCRT)后 6 个月内,其身体症状严重程度、功能状态、支持性护理需求的变化以及相关因素。
采用前瞻性纵向研究,纳入来自台湾北部一家医学中心 RT 诊所的口腔癌患者。在五个时间点评估患者的支持性护理需求和身体症状:RT 或 CCRT 开始前以及 RT 或 CCRT 开始后 1、2、3 和 6 个月。采用广义估计方程来确定总体需求以及六个特定需求维度的预测因素。
共有 82 例患者完成了 6 个月的随访。患者在 6 个月内的支持性护理需求处于中高度水平。尽管在治疗前阶段,患者的信息需求最高,但总体和个体护理需求的高峰出现在首次接受 RT 或 CCRT 后 2 个月。无宗教信仰的患者以及教育程度、功能水平、整体身体症状严重程度和基线焦虑较高的患者,报告的支持性护理需求更多。治疗前的焦虑水平是大多数支持性护理需求的最常见因素。个体身体症状,包括疲劳、吞咽困难和口腔黏膜炎,与较高的身体和日常生活需求显著相关。
有必要进行系统的临床评估,以检测患者的护理需求,从而改善及时的癌症护理提供,并满足患者的医疗保健需求。