接受程序性细胞死亡蛋白1免疫治疗的肺癌患者的症状群及其预测因素。
Symptom clusters and their predictors in patients with lung cancer and treated with programmed cell death protein 1 immunotherapy.
作者信息
Zhang Guolong, Weng Huiwen, Li Yinghong, Li Pingdong, Gong Yucui, Chen Jieya, Wei Lin, Zeng Linghui, Zeng Yingchun, Cheng Andy Sk
机构信息
School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China.
Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
出版信息
Asia Pac J Oncol Nurs. 2022 Jun 10;9(8):100103. doi: 10.1016/j.apjon.2022.100103. eCollection 2022 Aug.
OBJECTIVE
The aims of this study were to examine the symptom severity and interference among patients with lung cancer treated with PD-1 immunotherapy, explore whether those symptoms were clustered together, and identify factors associated with symptom clusters.
METHODS
A cross-sectional study was conducted. Data were collected by demographic and clinical characteristic questionnaires and the M.D. Anderson Symptom Inventory Lung Cancer Module. Symptom clusters were identified using exploratory factor analysis, and stepwise linear regression was applied to analyze the factors affecting the symptom clusters.
RESULTS
A total of 148 patients with lung cancer treated with PD-1 immunotherapy participated in this study. The overall symptom burdens of these patients were mainly at a mild level. The patient symptom clusters identified in this study were a general cluster, a treatment-related cluster, a pulmonary cluster, a gastrointestinal cluster, and a neural cluster. The patients' Karnofsky performance status (KPS) score ( = -2.758, < 0.001) and having a history of chemotherapy ( = 4.384, = 0.001) were significant predictors of the general cluster. Their KPS scores ( = -1.202, < 0.001) and having a history of chemotherapy ( = -1.957, = 0.001) were significant predictors of the pulmonary cluster. Their monthly income ( = -0.316, = 0.030) and KPS scores ( = -0.357, = 0.045) were significant predictors of the gastrointestinal cluster. Having a history of chemotherapy ( = 1.868, < 0.001) was the predictor of the neural cluster.
CONCLUSIONS
The symptom burdens of patients with lung cancer and treated with PD-1 immunotherapy were at a mild level and appeared to be clustered. In addition, because the symptoms that comprise a cluster are interrelated, the diagnosis and management of each symptom in a cluster should not be performed in isolation, and each symptom in a cluster should be treated either simultaneously or in an orderly manner.
目的
本研究旨在调查接受PD - 1免疫治疗的肺癌患者的症状严重程度及干扰情况，探讨这些症状是否聚集在一起，并确定与症状簇相关的因素。
方法
进行了一项横断面研究。通过人口统计学和临床特征问卷以及MD安德森症状量表肺癌模块收集数据。使用探索性因素分析确定症状簇，并应用逐步线性回归分析影响症状簇的因素。
结果
共有148例接受PD - 1免疫治疗的肺癌患者参与本研究。这些患者的总体症状负担主要处于轻度水平。本研究确定的患者症状簇为一般簇、治疗相关簇、肺部簇、胃肠道簇和神经簇。患者的卡氏功能状态（KPS）评分（β = - 2.758，P < 0.001）和有化疗史（β = 4.384，P = 0.001）是一般簇的显著预测因素。他们的KPS评分（β = - 1.202，P < 0.001）和有化疗史（β = - 1.957，P = 0.001）是肺部簇的显著预测因素。他们的月收入（β = - 0.316，P = 0.030）和KPS评分（β = - 0.357，P = 0.045）是胃肠道簇的显著预测因素。有化疗史（β = 1.868，P < 0.001）是神经簇的预测因素。
结论
接受PD - 1免疫治疗的肺癌患者的症状负担处于轻度水平且似乎聚集在一起。此外，由于构成一个簇的症状是相互关联的，因此不应孤立地对簇中的每个症状进行诊断和管理，而应同时或有序地治疗簇中的每个症状。
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