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具有不同注意力功能特征的老年肿瘤患者的共病症状。

Co-occuring symptoms in older oncology patients with distinct attentional function profiles.

机构信息

Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.

School of Nursing, University of California, San Francisco, CA, USA.

出版信息

Eur J Oncol Nurs. 2019 Aug;41:196-203. doi: 10.1016/j.ejon.2019.07.001. Epub 2019 Jul 2.

Abstract

PURPOSE

Evaluate how subgroups of older adults with distinct attentional function profiles differ on the severity of nine common symptoms and determine demographic and clinical characteristics and symptom severity scores associated with membership in the low and moderate attentional function classes.

METHODS

Three subgroups of older oncology outpatients were identified using latent profile analysis based on Attentional Function Index (AFI) scores. Symptoms were assessed prior to the second or third cycle of CTX. Logistic regressions evaluated for associations with attentional function class membership.

RESULTS

For trait anxiety, state anxiety, depression, sleep disturbance, morning fatigue, and evening fatigue scores, differences among the latent classes followed the same pattern (low > moderate > high). For morning and evening energy, compared to high class, patients in low and moderate classes reported lower scores. For pain, compared to moderate class, patients in low class reported higher scores. In the logistic regression analysis, compared to high class, patients with lower income, higher comorbidity, higher CTX toxicity score, and higher levels of state anxiety, depression, and sleep disturbance were more likely to be in low AFI class. Compared to high class, patients with higher comorbidity and trait anxiety and lower morning energy were more likely to be in moderate AFI class.

CONCLUSIONS

Consistent with the hypothesis that an increased risk for persistent cognitive decline is likely related to a variety of physical and psychological factors, for six of the nine symptoms, a "dose response" effect was observed with higher symptom severity scores associated with a progressive decline in attentional function.

摘要

目的

评估注意力功能特征不同的老年亚组在 9 种常见症状严重程度上的差异,并确定与低和中注意力功能类别成员身份相关的人口统计学和临床特征以及症状严重程度评分。

方法

使用基于注意力功能指数(AFI)评分的潜在剖面分析,确定了三组老年肿瘤门诊患者亚组。在接受 CTX 的第二或第三周期之前评估症状。逻辑回归评估与注意力功能分类成员资格相关的关联。

结果

对于特质焦虑、状态焦虑、抑郁、睡眠障碍、晨乏和晚乏评分,潜在类别之间的差异呈现相同模式(低>中>高)。与高类相比,中低类患者的晨暮能量得分较低。与中类相比,低类患者的疼痛得分较高。在逻辑回归分析中,与高类相比,收入较低、共病较多、CTX 毒性评分较高以及状态焦虑、抑郁和睡眠障碍水平较高的患者更有可能处于低 AFI 类。与高类相比,共病较多、特质焦虑和晨暮能量较低的患者更有可能处于中 AFI 类。

结论

与持续认知衰退风险增加可能与多种身体和心理因素有关的假设一致,对于 9 种症状中的 6 种,观察到与注意力功能进行性下降相关的更高症状严重程度评分的“剂量反应”效应。

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