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结直肠癌患者化疗后周围神经病变、日常生活活动障碍和抑郁的变化:一项前瞻性研究。

Changes in chemotherapy-induced peripheral neuropathy, disturbance in activities of daily living, and depression following chemotherapy in patients with colorectal cancer: A prospective study.

机构信息

Department of Nursing, Sahmyook University, Seoul, South Korea.

Korea Cancer Center Hospital, Seoul, South Korea.

出版信息

Eur J Oncol Nurs. 2020 Feb;44:101676. doi: 10.1016/j.ejon.2019.101676. Epub 2019 Nov 9.

Abstract

PURPOSE

This study was conducted to identify the changes in oxaliplatin-induced peripheral neuropathy (OIPN), disturbance in activities of daily living (ADL), and depression and their interrelationships during the cancer care trajectory in colorectal cancer patients.

METHODS

Eighty-six subjects participated in the study and completed the questionnaire at three time points: pre-chemotherapy, undergoing chemotherapy, and 3 months after the completion of chemotherapy. The assessment tools were Chemotherapy-Induced Peripheral Neuropathy 20 for OIPN, Chemotherapy-Induced Peripheral Neuropathy Assessment Tool to measure disturbances in ADL, and Hospital Anxiety and Depression Scale for depression. Data were analyzed using descriptive statistics and repeated-measures analysis of variance.

RESULTS

While undergoing chemotherapy, 37.2% of the patients complained of OIPN and 32.6% exhibited OIPN at 3-month follow-up. Repeated-measures analysis of variance showed a significant increase in OIPN after chemotherapy, which remained high at the 3-month follow-up. The most frequent symptom of OIPN was "tingling feeling in the hand and foot," and the second was "impotence." Disturbance in ADL by OIPN and depression showed similar patterns as OIPN. The mean score for disturbance in ADL of OIPN was 48.58. The mean score was 7.36 for depression, with a prevalence of 23.5%. There were significant correlations among the three variables, suggesting that OIPN may be casual in the OIPN- disturbance in ADL-depression symptom interrelationships.

CONCLUSION

These results suggest that chemotherapy is highly associated with OIPN, disturbance in ADL by OIPN, and depression in colorectal cancer patients. Nursing intervention is needed to relieve depression as well as OIPN in patients undergoing chemotherapy.

摘要

目的

本研究旨在识别结直肠癌患者在癌症治疗过程中奥沙利铂诱导的周围神经病变(OIPN)、日常生活活动(ADL)障碍和抑郁的变化及其相互关系。

方法

86 名受试者参与了这项研究,并在三个时间点完成了问卷:化疗前、化疗期间和化疗结束后 3 个月。评估工具包括用于 OIPN 的化疗诱导的周围神经病 20 项、用于测量 ADL 障碍的化疗诱导的周围神经病评估工具和用于抑郁的医院焦虑和抑郁量表。使用描述性统计和重复测量方差分析对数据进行分析。

结果

在化疗期间,37.2%的患者抱怨有 OIPN,3 个月随访时有 32.6%的患者出现 OIPN。重复测量方差分析显示,化疗后 OIPN 显著增加,在 3 个月随访时仍保持较高水平。OIPN 最常见的症状是“手脚刺痛感”,其次是“阳痿”。OIPN 引起的 ADL 障碍和抑郁表现出相似的模式。OIPN 的 ADL 障碍的平均得分为 48.58。抑郁的平均得分为 7.36,患病率为 23.5%。这三个变量之间存在显著相关性,表明 OIPN 可能在 OIPN-ADL 障碍-抑郁症状相互关系中起因果作用。

结论

这些结果表明,化疗与结直肠癌患者的 OIPN、OIPN 引起的 ADL 障碍和抑郁密切相关。需要进行护理干预,以缓解接受化疗的患者的抑郁和 OIPN。

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