Linder Lauri A, Al-Qaaydeh Sharifa, Donaldson Gary
Author Affiliations: College of Nursing (Dr Linder and Ms Al-Qaaydeh) and Department of Anesthesiology (Dr Donaldson) University of Utah; and Cancer, Blood, and Transplant Service, Primary Children's Hospital (Dr Linder), Salt Lake City, Utah.
Cancer Nurs. 2018 Jan/Feb;41(1):23-32. doi: 10.1097/NCC.0000000000000469.
Studies addressing physical and psychosocial symptoms among hospitalized children and adolescents with cancer are limited. Understanding commonly occurring symptoms and their associated characteristics across the hospitalization is needed to guide symptom management strategies.
This study described the symptom experience of hospitalized children and adolescents with cancer. The study explored the frequencies of individual symptoms and the severity, duration, and associated distress of symptoms during the course of the hospitalization.
Participants completed the Memorial Symptom Assessment Scale 7-12 during each 12-hour shift of the 3-day/3-night data collection period.
Participants were 50 children and adolescents (mean age, 12.6 years; range, 7.1-18.6 years) receiving inpatient chemotherapy. Participants reported a mean of 2.75 symptoms at each assessment point and a mean of 5.42 different symptoms during their hospitalization. Mixed model analyses identified a significant fixed effect for study day, with participants reporting fewer symptoms (F = 8.4, P < .01), less symptom severity (F = 5.81, P < .01), and shorter duration (F = 6.67, P < .01) on day 3 relative to days 1 and 2. A fixed effect for study day was not present for symptom distress.
Children and adolescents receiving inpatient chemotherapy experience multiple physical and psychosocial symptoms of moderate or greater severity and duration throughout the course of their hospitalization. Symptoms of greatest severity may not be those that are most distressing to the patient.
Ongoing assessment that incorporates the multidimensional nature of symptoms is needed. Prioritizing interventions for symptoms that are most distressing to the patient may support a more meaningful, patient-centric approach to care.
针对住院癌症儿童和青少年的身体及心理社会症状的研究有限。需要了解住院期间常见症状及其相关特征，以指导症状管理策略。
本研究描述了住院癌症儿童和青少年的症状体验。该研究探讨了个体症状的发生频率以及住院期间症状的严重程度、持续时间和相关痛苦程度。
在为期3天/3夜的数据收集期间，参与者在每个12小时轮班时完成纪念症状评估量表7 - 12。
参与者为50名接受住院化疗的儿童和青少年（平均年龄12.6岁；范围7.1 - 18.6岁）。参与者在每个评估点平均报告2.75种症状，住院期间平均报告5.42种不同症状。混合模型分析确定研究日有显著的固定效应，与第1天和第2天相比，参与者在第3天报告的症状较少（F = 8.4，P <.01）、症状严重程度较低（F = 5.81，P <.01）且持续时间较短（F = 6.67，P <.01）。症状痛苦程度方面不存在研究日的固定效应。
接受住院化疗的儿童和青少年在住院期间经历多种中度或更严重程度及持续时间的身体和心理社会症状。最严重的症状可能并非对患者最困扰的症状。
需要进行纳入症状多维度性质的持续评估。优先干预对患者最困扰的症状可能支持更有意义、以患者为中心的护理方法。
