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癌症相关性症状在接受乳腺癌化疗的中青年女性中的表现:潜在类别分析和网络分析的应用。

Cancer-related symptoms among young and middle-aged women undergoing chemotherapy for breast cancer: Application of latent class analysis and network analysis.

机构信息

Fudan University, School of Nursing, Shanghai, China.

Fudan University, School of Nursing, Shanghai, China.

出版信息

Eur J Oncol Nurs. 2023 Apr;63:102287. doi: 10.1016/j.ejon.2023.102287. Epub 2023 Feb 10.

Abstract

PURPOSE

To identify subgroups and symptom networks of cancer-related symptoms for women under 60 years who are undergoing chemotherapy for breast cancer.

METHODS

A cross-sectional survey in Mainland China was conducted between August 2020 and November 2021. Participants completed questionnaires that collected demographic and clinical characteristics and featured the PROMIS-57 and the PROMIS-Cognitive Function Short Form.

RESULTS

A total of 1033 participants were included in the analysis, and three-class model was identified: "severe symptom group" (17.6%; Class 1), "moderately severe anxiety, depression, and pain-interference group" (38.0%; Class 2), and "mild symptom group" (44.4%; Class 3). Patients who were in menopause (OR = 3.05, P < .001), undergoing a combination of medical treatments (OR = 2.39, P = .003), and who had experienced complications (OR = 1.86, P = .009) were more likely to belong to Class 1. However, having two or more children increased the likelihood of belonging to Class 2. Additionally, network analysis showed that severe fatigue level was the core symptom among the full sample. As for Class 1, feeling helpless and severe fatigue level were the core symptoms. Regarding Class 2, the impact of pain interfere on the ability to participate in social activities and feeling hopeless were found to be the targeted symptoms for intervention.

CONCLUSION

Menopause, receiving a combination of medical treatments, and experiencing complications characterize the group with the most symptom disturbance. Moreover, different interventions should be performed for core symptoms in patients with varied symptom disturbances.

摘要

目的

确定接受乳腺癌化疗的 60 岁以下女性的癌症相关症状亚组和症状网络。

方法

2020 年 8 月至 2021 年 11 月在中国内地进行了一项横断面调查。参与者完成了调查问卷,收集了人口统计学和临床特征,并包括 PROMIS-57 和 PROMIS-认知功能简短表。

结果

共纳入 1033 名参与者,确定了三分类模型:“严重症状组”(17.6%;第 1 类)、“中重度焦虑、抑郁和疼痛干扰组”(38.0%;第 2 类)和“轻度症状组”(44.4%;第 3 类)。处于绝经期(OR=3.05,P<0.001)、接受联合治疗(OR=2.39,P=0.003)和经历并发症(OR=1.86,P=0.009)的患者更有可能属于第 1 类。然而,有两个或更多孩子的患者更有可能属于第 2 类。此外,网络分析显示,严重疲劳水平是全样本的核心症状。对于第 1 类,无助感和严重疲劳水平是核心症状。对于第 2 类,发现疼痛干扰对参与社会活动的能力和绝望感的影响是干预的靶向症状。

结论

绝经期、接受联合治疗和经历并发症是症状最紊乱组的特征。此外,对于不同症状紊乱的患者,应针对核心症状进行不同的干预。

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