神经心理学症状和侵入性思维与化疗引起的恶心的更差的轨迹有关。
Neuropsychological Symptoms and Intrusive Thoughts Are Associated With Worse Trajectories of Chemotherapy-Induced Nausea.
机构信息
Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.
School of Nursing, University of California, San Francisco, California, USA.
出版信息
J Pain Symptom Manage. 2020 Mar;59(3):668-678. doi: 10.1016/j.jpainsymman.2019.10.023. Epub 2019 Nov 2.
CONTEXT
Although chemotherapy-induced vomiting is well controlled with evidence-based antiemetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem.
OBJECTIVES
Study purposes, in a sample of outpatients with breast, gastrointestinal, gynecological, or lung cancer who received two cycles of chemotherapy (CTX, n = 1251), were to evaluate for interindividual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN.
METHODS
Patients were recruited during their first or second cycle of CTX. Patients completed self-report questionnaires a total of six times over two cycles of CTX. Hierarchical linear modeling was used to evaluate for interindividual differences in and characteristics associated with the severity of CIN.
RESULTS
Across the two cycles of CTX, higher levels of sleep disturbance, depression, and morning fatigue, as well as higher levels of intrusive thoughts, were associated with higher initial levels of CIN. In addition, lower functional status scores and shorter cycle lengths were associated with higher initial levels of CIN, and younger age and higher emetogenicity of the CTX regimen were associated with both higher initial levels as well as worse trajectories of CIN severity.
CONCLUSION
These findings suggest that common symptoms associated with cancer and its treatment are associated with increased severity of CIN. Targeted interventions for these symptoms may reduce the burden of unrelieved CIN.
背景
尽管基于循证的止吐方案可有效控制化疗引起的呕吐，但化疗引起的恶心（CIN）仍然是一个严重的临床问题。
目的
本研究在接受两个周期化疗（CTX，n=1251）的乳腺癌、胃肠道癌、妇科癌或肺癌门诊患者中进行，目的是评估 CIN 严重程度的个体间差异，并确定哪些人口统计学、临床、症状和应激特征与较高的初始水平以及 CIN 的轨迹相关。
方法
在 CTX 的第一或第二周期期间招募患者。患者在 CTX 的两个周期内共完成了六次自我报告问卷调查。使用分层线性模型评估 CIN 严重程度的个体间差异和与 CIN 严重程度相关的特征。
结果
在 CTX 的两个周期中，睡眠障碍、抑郁和早晨疲劳程度较高，以及侵入性思维程度较高，与 CIN 的初始水平较高相关。此外，功能状态评分较低和周期长度较短与 CIN 的初始水平较高相关，而年龄较小和 CTX 方案的致吐性较高与 CIN 的初始水平以及严重程度的恶化轨迹相关。
结论
这些发现表明，与癌症及其治疗相关的常见症状与 CIN 的严重程度增加有关。针对这些症状的针对性干预措施可能会减轻未缓解的 CIN 的负担。
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