Denieffe Suzanne, Cowman Seamus, Gooney Martina
Department of Nursing, Waterford Institute of Technology, Waterford, Ireland.
J Clin Nurs. 2014 Sep;23(17-18):2491-502. doi: 10.1111/jocn.12430. Epub 2013 Dec 14.
To examine the pretreatment symptoms and symptom clusters that women awaiting breast cancer surgery are experiencing and the impact of these symptoms on their quality of life.
Most women diagnosed with breast cancer will have surgery as a first-line treatment. The presence of presurgery symptoms may be significant in contributing to distress and impaired quality of life. While it seems that women with breast cancer may experience the symptoms of fatigue, pain, depression and sleep disturbance as a cluster, this has not yet been confirmed by empirical research in the presurgery time period.
A multiple-point prospective longitudinal cohort panel design is used.
Presurgery symptoms and quality of life were assessed using the Hospital Anxiety and Depression Scale, Insomnia Severity Index, Functional Assessment of Cancer Therapy-Fatigue, Brief Pain Inventory and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(3).
Participants (n = 94, age range 30-92) experienced symptoms prior to surgery, with pain being a more prevalent symptom (35%) than fatigue (32%), sleep disturbances (25·5%) or depression (11%). global quality of life was significantly impacted on by fatigue and showed a moderate correlation with emotional functioning and a weak correlation with physical and social functioning. Hierarchical cluster analysis identified the presence of five clusters with symptoms present in differing intensities in each cluster.
In this cohort of women, healthy other than having a diagnosis of breast cancer, symptoms were impacting on quality of life. It is evident that clusters of symptoms are present presurgery that must be assessed and managed.
Healthcare delivery systems must ensure that early symptoms are addressed effectively in the presurgery period to improve quality of life and reduce adverse outcomes postsurgery.
研究等待乳腺癌手术的女性术前症状及症状群，以及这些症状对其生活质量的影响。
大多数被诊断为乳腺癌的女性会将手术作为一线治疗手段。术前症状的存在可能在导致痛苦和生活质量受损方面具有重要影响。虽然乳腺癌女性似乎可能会出现疲劳、疼痛、抑郁和睡眠障碍等症状群，但这尚未在术前时间段的实证研究中得到证实。
采用多点前瞻性纵向队列面板设计。
使用医院焦虑抑郁量表、失眠严重程度指数、癌症治疗功能评估-疲劳量表、简明疼痛量表以及欧洲癌症研究与治疗组织生活质量问卷核心30（EORTC QLQ-C30）对术前症状和生活质量进行评估。
参与者（n = 94，年龄范围30 - 92岁）在手术前出现了症状，其中疼痛是比疲劳（32%）、睡眠障碍（25.5%）或抑郁（11%）更普遍的症状（35%）。总体生活质量受到疲劳的显著影响，并且与情绪功能呈中度相关，与身体和社会功能呈弱相关。层次聚类分析确定存在五个症状群，每个群中症状的强度不同。
在这组除患有乳腺癌外身体健康的女性中，症状对生活质量产生了影响。显然，术前存在症状群，必须对其进行评估和管理。
医疗保健提供系统必须确保在术前阶段有效解决早期症状，以提高生活质量并减少术后不良后果。
