Chan Carmen W H, Richardson Alison, Richardson Janet
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR.
Contemp Nurse. 2013 Oct;45(2):164-73. doi: 10.5172/conu.2013.45.2.164.
The investigation of the clustering of symptoms in patients with cancer is still at an early stage. Initial evidence suggests symptoms such as breathlessness, fatigue and anxiety occur concurrently.
The purpose of this study was to investigate the existence of a symptom cluster involving breathlessness, fatigue and anxiety in Chinese patients with advanced lung cancer undergoing palliative radiotherapy (RT).
The study was conducted in an oncology out-patient unit of a publicly funded hospital in Hong Kong. A convenience sample of 140 patients were asked to complete a set of questionnaires at four time points including the A-state scale of the State-Trait Anxiety Inventory, a breathlessness visual analog scale and the intensity subscale of the revised Piper Fatigue Scale at four points: 1 day prior to RT (baseline) (T0), and at week 3 (T1), week 6 (T2) and week 12 (T3) after the commencement of the RT.
Between 64-73% of patients experienced all three symptoms concurrently across T0-T3. The prevalence of anxiety, fatigue and breathlessness ranged from 65-97% respectively. Intensities of breathlessness and fatigue were highest at T1. Significant correlations between the three symptoms were moderate across time (r < 0.50).
The high prevalence of the symptom cluster demonstrates a need to assess and manage these symptoms simultaneously in patients with advanced lung cancer.
对癌症患者症状群集的研究仍处于早期阶段。初步证据表明，诸如呼吸困难、疲劳和焦虑等症状会同时出现。
本研究旨在调查接受姑息性放疗（RT）的中国晚期肺癌患者中，是否存在由呼吸困难、疲劳和焦虑组成的症状群。
该研究在香港一家公立医院的肿瘤科门诊进行。选取140例便利样本患者，要求他们在四个时间点完成一组问卷，包括状态-特质焦虑量表的A状态量表、呼吸困难视觉模拟量表以及修订版派珀疲劳量表的强度分量表，这四个时间点分别为：放疗前1天（基线）（T0），以及放疗开始后的第3周（T1）、第6周（T2）和第12周（T3）。
在T0至T3期间，64%至73%的患者同时出现了所有这三种症状。焦虑、疲劳和呼吸困难的患病率分别在65%至97%之间。呼吸困难和疲劳的强度在T1时最高。这三种症状之间的显著相关性在各个时间点均为中等程度（r < 0.50）。
该症状群的高患病率表明，有必要对晚期肺癌患者的这些症状进行同时评估和管理。
