Department of Psychooncology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing, Peking University Cancer Hospital & Institute, Beijing, China.
Psychooncology. 2020 May;29(5):869-877. doi: 10.1002/pon.5358. Epub 2020 Feb 24.
Distress screening using measures of patient-reported outcomes (PRO) has been introduced in China and is increasingly recognized as contributing to whole-patient care. We carried out a multi-centered cross-sectional survey of Chinese cancer inpatients to explore the symptom burden, symptom clusters, and risk factors of distress.
Patients were recruited from five hospitals in four provinces. The Distress Assessment and Response Tool (DART) was used as the screening tool. Demographic and medical information was collected. Descriptive analysis, the chi-square test, logistics regression analysis, and hierarchical clustering analysis were used.
Totally 1045 valid questionnaires were collected (83.6% validity ratio). Low well-being (39.4%), lack of appetite (35.4%), tiredness (32.9%), pain (21.1%), and anxiety (19.8%) were the top five symptoms. Patients in Ci County had a heavier symptom burden than patients at other sites. Depression, anxiety, nausea, drowsiness, and pain were considered pain-illness symptoms; lack of appetite, low well-being, tiredness, and shortness of breath were considered fatigue-illness symptoms. Social difficulty was a risk factor for all symptoms. A high proportion of suicide ideation (38.8%) and suicide intention (10.5%) was identified among patients with potential depression.
The high symptom burden of Chinese cancer inpatients indicates the necessity of distress screening; well-designed screening programs such as the multidimensional DART and its acceptability in China should be further explored. Social difficulty has a universal impact on patients' well-being, and psychosocial care should be integrated into holistic symptoms management.
采用患者报告结局（PRO）测量方法进行痛苦筛查已在中国引入，并日益被认为有助于整体患者护理。我们对中国癌症住院患者进行了一项多中心横断面调查，以探讨其痛苦负担、症状群和危险因素。
从中国四个省的五家医院招募患者。采用痛苦评估与应对工具（DART）作为筛查工具。收集人口统计学和医疗信息。采用描述性分析、卡方检验、逻辑回归分析和层次聚类分析。
共收集了 1045 份有效问卷（有效率为 83.6%）。幸福感低（39.4%）、食欲不振（35.4%）、疲倦（32.9%）、疼痛（21.1%）和焦虑（19.8%）是前五种症状。与其他地点的患者相比，Ci 县的患者症状负担更重。抑郁、焦虑、恶心、困倦和疼痛被认为是疼痛疾病症状；食欲不振、幸福感低、疲倦和呼吸急促被认为是疲劳疾病症状。社会困难是所有症状的一个危险因素。在有潜在抑郁的患者中，自杀意念（38.8%）和自杀意图（10.5%）的比例较高。
中国癌症住院患者的高症状负担表明需要进行痛苦筛查；应进一步探索多维 DART 等精心设计的筛查方案及其在中国的可接受性。社会困难对患者的幸福感具有普遍影响，应将心理社会护理纳入整体症状管理。
