Department of Health Psychology, School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China.
Eur J Oncol Nurs. 2020 Oct;48:101819. doi: 10.1016/j.ejon.2020.101819. Epub 2020 Aug 5.
The point of view of symptom clusters (SCs) may develop an efficient symptom management strategy to enhance health-related quality of life (HRQoL) in head and neck (HNC) patients with endotracheal tube (ETT). The study aims to investigate the possible SCs in HNC patients with ETT and determine whether there was an independent relationship between one or more SCs and HRQoL.
A cross-sectional study design was adopted, and 203 HNC patients with ETT were recruited. They took measurements of General Information Questionnaire, MD Anderson Symptom Inventory-Head & Neck, and Twelve-Item Short-Form Health Survey (SF-12). Spearman correlations, partial correlations, and hierarchical cluster analysis were performed to determine latent number of SCs, and covariance analyses were used to determine independent associations between SCs and SF-12. This study followed STROBE Statement.
Pain SCs (pain, distressed, short of breath, and sadness), fatigue SCs (fatigue/weakness, restless, and sleepy), digestive SCs (appetite loss, constipation, and nausea), HNC-specific SCs (dry mouth and mucus), and tracheostomy-related SCs (difficulty swallowing and difficulty with voice and speech) were found. After adjusting covariant variables, this study found independent relationships of pain SCs and fatigue SCs with physical component summary of SF-12, and between fatigue SCs and mental component summary of SF-12.
Multiple SCs were found in those HNC patients. Pain SCs and fatigue SCs were independently associated with HRQoL. In process of caring HNC patients with ETT, it is vital to focus on SCs, especially on pain SCs and fatigue SCs, which might effectively improve patients' HRQoL.
症状群（SCs）的观点可能会制定出有效的症状管理策略，以提高带气管插管（ETT）的头颈部（HNC）患者的健康相关生活质量（HRQoL）。本研究旨在调查带 ETT 的 HNC 患者中可能存在的 SCs，并确定一个或多个 SCs 与 HRQoL 是否存在独立关系。
采用横断面研究设计，共纳入 203 例带 ETT 的 HNC 患者。他们接受了一般信息问卷、MD 安德森症状清单-头颈部和 12 项简明健康调查量表（SF-12）的测量。采用 Spearman 相关分析、偏相关分析和层次聚类分析来确定潜在的 SC 数量，并采用协方差分析来确定 SCs 与 SF-12 之间的独立关联。本研究遵循 STROBE 声明。
发现疼痛 SCs（疼痛、苦恼、呼吸急促和悲伤）、疲劳 SCs（疲劳/虚弱、不安和困倦）、消化 SCs（食欲减退、便秘和恶心）、HNC 特异性 SCs（口干和粘液）和气管造口术相关 SCs（吞咽困难、语音和言语困难）。在调整协变量后，本研究发现疼痛 SCs 和疲劳 SCs 与 SF-12 的生理成分综合评分以及疲劳 SCs 与 SF-12 的心理成分综合评分之间存在独立关系。
在这些 HNC 患者中发现了多个 SCs。疼痛 SCs 和疲劳 SCs 与 HRQoL 独立相关。在照顾带 ETT 的 HNC 患者时，关注 SCs 至关重要，特别是疼痛 SCs 和疲劳 SCs，这可能会有效提高患者的 HRQoL。
