Choi S, Ryu E
Department of Nursing, National Cancer Center, Kyunggi-do, South Korea.
Department of Nursing, Chung-Ang University, Seoul, South Korea.
Eur J Cancer Care (Engl). 2018 Jan;27(1). doi: 10.1111/ecc.12508. Epub 2016 Apr 26.
People with advanced lung cancer experience later symptoms after treatment that is related to poorer psychosocial and quality of life (QOL) outcomes. The purpose of this study was to identify the effect of symptom clusters and depression on the QOL of patients with advanced lung cancer. A sample of 178 patients with advanced lung cancer at the National Cancer Center in Korea completed a demographic questionnaire, the M.D. Anderson Symptom Inventory-Lung Cancer, the Center for Epidemiological Studies Depression Scale, and the Functional Assessment of Cancer Therapy-General scale. The most frequently experienced symptom was fatigue, anguish was the most severe symptom-associated distress, and 28.9% of participants were clinically depressed. Factor analysis was used to identify symptom clusters based on the severity of patients' symptom experiences. Three symptom clusters were identified: treatment-associated, lung cancer and psychological symptom clusters. The regression model found a significant negative impact on QOL for depression and lung cancer symptom cluster. Age as the control variable was found to be significant impact on QOL. Therefore, psychological screening and appropriate intervention is an essential part of advanced cancer care. Both pharmacological and non-pharmacological approaches for alleviating depression may help to improve the QOL of lung cancer patients.
晚期肺癌患者在治疗后会出现较晚的症状，这些症状与较差的心理社会状况和生活质量（QOL）结果相关。本研究的目的是确定症状群和抑郁对晚期肺癌患者生活质量的影响。韩国国立癌症中心的178例晚期肺癌患者样本完成了一份人口统计学调查问卷、MD安德森肺癌症状量表、流行病学研究中心抑郁量表和癌症治疗功能评估通用量表。最常出现的症状是疲劳，痛苦是最严重的症状相关困扰，28.9%的参与者有临床抑郁。基于患者症状体验的严重程度，采用因子分析来识别症状群。识别出三个症状群：治疗相关、肺癌和心理症状群。回归模型发现抑郁和肺癌症状群对生活质量有显著的负面影响。年龄作为控制变量被发现对生活质量有显著影响。因此，心理筛查和适当干预是晚期癌症护理的重要组成部分。缓解抑郁的药物和非药物方法都可能有助于提高肺癌患者的生活质量。
