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在接受紫杉醇治疗的乳腺癌患者中,症状状况、身体感知与焦虑和抑郁风险的关系:一项前瞻性纵向研究。

Symptom status, body perception, and risk of anxiety and depression in breast cancer patients receiving paclitaxel: a prospective longitudinal study.

机构信息

Ankara City Hospital, Bilkent Street No:1, Çankaya, Ankara, Turkey.

Internal Medicine Nursing Department, Turkey Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey.

出版信息

Support Care Cancer. 2022 Mar;30(3):2069-2079. doi: 10.1007/s00520-021-06619-6. Epub 2021 Oct 17.

Abstract

BACKGROUND

Paclitaxel regimen which is widely used in clinical treatment causes many negative physical and psychological consequences on women with breast cancer (BC). This longitudinal study firstly aimed to investigate symptom status, body perception changes, and the risk of anxiety and depression in BC patients receiving during paclitaxel regimen.

MATERIALS AND METHODS

This descriptive and prospective study was conducted with 84 BC patients receiving paclitaxel regimen. "Chemotherapy Symptom Assessment Scale (C-SAS)," "Body Perception Scale (BPS)," and "Hospital Anxiety and Depression Scale (HADS)" were applied at five time points (T, before the first Paclitaxel infusion; T, at the end of first cycle; T, at the end of fourth cycle; T, at the end of eighth cycle; T, at the end of twelfth cycle). Data was analyzed using descriptive statistics, Cochrane Q, and linear mix model regression analysis.

RESULTS

The frequency of needling and numbness in hands and feet, pain, and skin or nail changes significantly increased in the subsequent assessment points (T, T, T, and T) compared to the initial assessment (T) (p < 0.05). The mean scores of BPS significantly decreased at T, T, and T compared to T (F = 8.152, p < 0.001). The mean scores of the anxiety subscale of the HADS scale decreased at the T, T, and T compared to T (F = 6.865, p < 0.001), and the mean scores of the depression subscale significantly increased at the T compared to T (F = 3.708, p = 0.006).

CONCLUSIONS

The oncology nurse should comprehensively evaluate the patients who scheduled to receive paclitaxel treatment, and provide counseling to the patients during these specific weeks. Better management of the symptoms that increase with the paclitaxel regimen with repeated interviews under the supervision of the nurse will also prevent the deterioration of body perception. In addition, since the risk of depression increases over time in patients receiving paclitaxel, nurses should periodically screen the risk of depression, and timely consult the patients for the appropriate support.

摘要

背景

紫杉醇方案在临床治疗中广泛应用,但会给乳腺癌(BC)患者带来许多负面的身心后果。本纵向研究首先旨在探讨接受紫杉醇方案治疗的 BC 患者的症状状况、身体感知变化,以及焦虑和抑郁的风险。

材料和方法

本研究为描述性和前瞻性研究,共纳入 84 例接受紫杉醇方案治疗的 BC 患者。在五个时间点(T,首次紫杉醇输注前;T,第一周期结束时;T,第四周期结束时;T,第八周期结束时;T,第十二周期结束时)应用“化疗症状评估量表(C-SAS)”、“身体感知量表(BPS)”和“医院焦虑和抑郁量表(HADS)”。采用描述性统计、Cochrane Q 和线性混合模型回归分析进行数据分析。

结果

与初始评估(T)相比,后续评估点(T、T、T 和 T)时手和脚刺痛和麻木、疼痛、皮肤或指甲变化的发生频率显著增加(p<0.05)。与 T 相比,T、T 和 T 时 BPS 的平均得分显著降低(F=8.152,p<0.001)。与 T 相比,HADS 量表焦虑亚量表的平均得分在 T、T 和 T 时降低(F=6.865,p<0.001),抑郁亚量表的平均得分在 T 时显著升高与 T(F=3.708,p=0.006)。

结论

肿瘤护士应全面评估计划接受紫杉醇治疗的患者,并在这些特定周期间为患者提供咨询。在护士的监督下,通过反复访谈更好地管理随着紫杉醇方案而增加的症状,也将防止身体感知恶化。此外,由于接受紫杉醇治疗的患者随着时间的推移抑郁风险增加,护士应定期筛查抑郁风险,并及时为患者提供适当的支持。

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