Tang Chia-Chun, Von Ah Diane, Fulton Janet S
Author Affiliations: School of Nursing, Indiana University Purdue University at Indianapolis.
Cancer Nurs. 2018 Jan/Feb;41(1):33-44. doi: 10.1097/NCC.0000000000000463.
Pancreatic cancer is a devastating disease with limited treatment options. More than 80% of pancreatic cancers are diagnosed in advanced stages and often have debilitating symptoms, making symptom management paramount, yet the symptom experience of patients with advanced pancreatic cancer (APC) is not well understood.
The purpose of this integrative review is to synthesize the current evidence regarding the symptom experience of patients with APC.
An integrative literature review was conducted to identify the patient symptom experience in studies published from 2005 to 2015.
Sixteen studies met the inclusion criteria. All studies used a quantitative approach; 44% were quasi-experimental, 31% were descriptive, and 25% were correlational. Physical symptoms, especially pain, were the primary focus in most studies. Fatigue, loss of appetite, and impaired sense of well-being were prevalent and reported by patients to be of high intensity. Few studies examined psychological symptoms in patients with APC, although anxiety and depression were noted.
Findings suggest that physical and psychological symptoms are prevalent, some with high intensity. Preselection of symptom inventories limits our ability to fully understand the symptom experience of patients with APC. Future qualitative work is needed to provide a more in-depth understanding of symptoms, especially symptom quality and distress level, from patients' perspectives. More studies are needed to explore psychological symptoms and the interaction of physical and psychological symptoms.
Findings help healthcare givers to better understand the symptom experience of their APC patients.
胰腺癌是一种极具毁灭性的疾病，治疗选择有限。超过80%的胰腺癌在晚期被诊断出来，且常常伴有使人虚弱的症状，这使得症状管理至关重要，但晚期胰腺癌（APC）患者的症状体验尚未得到充分了解。
本整合性综述的目的是综合目前关于APC患者症状体验的证据。
进行了一项整合性文献综述，以确定2005年至2015年发表的研究中患者的症状体验。
16项研究符合纳入标准。所有研究均采用定量方法；44%为准实验性研究，31%为描述性研究，25%为相关性研究。身体症状，尤其是疼痛，是大多数研究的主要关注点。疲劳、食欲不振和幸福感受损很普遍，患者报告这些症状强度很高。很少有研究考察APC患者的心理症状，不过焦虑和抑郁被提及。
研究结果表明，身体和心理症状普遍存在，有些症状强度很高。症状量表的预先选择限制了我们全面了解APC患者症状体验的能力。未来需要开展定性研究，以便从患者角度更深入地了解症状，尤其是症状的性质和痛苦程度。需要更多研究来探索心理症状以及身体和心理症状的相互作用。
研究结果有助于医护人员更好地了解他们的APC患者的症状体验。
