多种慢性疾病对实体瘤癌症患者症状群的影响。
The Influence of Multiple Chronic Conditions on Symptom Clusters in People With Solid Tumor Cancers.
机构信息
Authors' affiliation: University of Iowa College of Nursing, Iowa City.
出版信息
Cancer Nurs. 2022;45(1):E279-E290. doi: 10.1097/NCC.0000000000000915.
BACKGROUND
People with cancer who also have multiple chronic conditions (MCCs) experience co-occurring symptoms known as symptom clusters.
OBJECTIVE
To describe MCC and symptom clusters in people with cancer and to evaluate the relationships between MCCs and symptom severity, symptom interference with daily life, and quality of life (QoL).
METHODS
Weekly over a 3-week chemotherapy cycle, 182 adults with solid tumor cancer receiving chemotherapy completed measures of symptom severity, symptom interference with daily life, and QoL. Medical records reviewed to count number of MCCs in addition to cancer. Exploratory factor analysis was performed to identify symptom clusters. The relationships between the number of MCCs and the outcomes (symptom severity and symptom interference with daily life and QoL) at each time point were examined using the χ2 test. Longitudinal changes in outcomes were examined graphically.
RESULTS
The number of MCCs ranged from 0 to 9, but most participants (62.1%) had 2 or fewer MCCs. Obesity was the most prevalent chronic condition. Four symptom clusters were identified: nutrition, neurocognitive, abdominal discomfort, and respiratory clusters. At each time point, no significant differences were found for MCCs and any outcome. However, symptom severity in all the symptom clusters, symptom interference with daily life, and QoL demonstrated a worsening in the week following chemotherapy.
CONCLUSION
A majority of our sample had 2 or fewer MCCs, and MCCs did contribute to patient outcomes. Rather, timing of chemotherapy cycle had the greatest influence of patient outcomes.
IMPLICATIONS FOR PRACTICE
Additional support on day 7 of chemotherapy treatment is needed for people with MCCs.
背景
患有癌症且同时患有多种慢性疾病（MCC）的人会出现同时出现的症状，称为症状群。
目的
描述癌症患者的 MCC 和症状群，并评估 MCC 与症状严重程度、症状对日常生活的干扰以及生活质量（QoL）之间的关系。
方法
在 3 周的化疗周期内，每周对 182 名接受化疗的实体瘤癌症成人完成症状严重程度、症状对日常生活的干扰和 QoL 的测量。回顾病历以计算除癌症以外的 MCC 数量。进行探索性因素分析以确定症状群。使用 χ2 检验检查每个时间点 MCC 数量与结果（症状严重程度和症状对日常生活的干扰以及 QoL）之间的关系。通过图形检查结果的纵向变化。
结果
MCC 的数量范围从 0 到 9，但大多数参与者（62.1%）有 2 个或更少的 MCC。肥胖是最常见的慢性疾病。确定了四个症状群：营养、神经认知、腹部不适和呼吸群。在每个时间点，MCC 和任何结果之间均无显着差异。然而，所有症状群的症状严重程度、症状对日常生活的干扰以及 QoL 在化疗后一周内均有所恶化。
结论
我们的样本大多数有 2 个或更少的 MCC，MCC 确实对患者的结果有影响。然而，化疗周期的时间对患者的结果影响最大。
实践意义
需要在化疗治疗的第 7 天为患有 MCC 的人提供额外的支持。
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