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鼻咽癌出院患者放化疗后的症状群

Symptom clusters after chemoradiotherapy in discharged nasopharyngeal carcinoma patients.

作者信息

Li Xiang, Fu Gui-Fen, Huang Yu-Ying, Jiang Qing-Yu, Huang Xiao-Yan, Zhang Jin-Tao, Qu Shen-Hong

机构信息

Department of Otorhinolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China.

Department of Nursing, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China.

出版信息

Front Oncol. 2023 Jun 14;13:920889. doi: 10.3389/fonc.2023.920889. eCollection 2023.

Abstract

OBJECTIVE

To investigate the incidence of complications and types of chemoradiotherepy induces symptom clusters in patients with nasopharyngeal carcinoma (NPC) who were first diagnosed after treatment and discharged from hospital.

METHODS

After their discharge home, 130 NPC patients who had been treated with chemoradiotherapy were asked to complete a modified Chinese version of the developed by the European Organization for the Research and Treatment of Cancer in the Head and Neck. Symptom clusters in patients were identified through exploratory factor analysis.

RESULTS

The most serious symptoms for discharged NPC patients who had received chemoradiotherapy were dental problems, a sense of obstruction while swallowing, embarrassment in physical contact with family members and friends, difficulty in speaking with others, and embarrassment in public. The six symptom clusters identified through exploratory factor analysis were (1) painful eating, (2) social difficulties, (3) psychological disorders, (4) symptomatic shame, (5) teeth/throat injuries, and (6) sensory abnormalities. The total contribution rate of variance was 65.73%.

CONCLUSION

NPC patients who are treated with chemoradiotherapy can experience adverse symptom clusters that continue after discharge. Nurses should evaluate the patients' symptoms before discharge and provide targeted health education services which would reduce the patients' complications and improve the quality of life at home. Besides, medical staff should evaluate the complications in a timely and comprehensive manner and provide individualized health education for the affected patients to help them manage chemoradiotherapy side effects.

摘要

目的

调查首次诊断并经治疗出院后的鼻咽癌(NPC)患者中并发症的发生率以及放化疗诱发症状群的类型。

方法

130例接受放化疗的NPC患者出院回家后,被要求完成一份由欧洲癌症研究与治疗组织头颈组开发的中文版改良版问卷。通过探索性因素分析确定患者的症状群。

结果

接受放化疗的出院NPC患者最严重的症状是牙齿问题、吞咽梗阻感、与家人和朋友身体接触时感到尴尬、与他人交谈困难以及在公共场合感到尴尬。通过探索性因素分析确定的六个症状群为:(1)进食疼痛,(2)社交困难,(3)心理障碍,(4)症状性羞耻感,(5)牙齿/咽喉损伤,(6)感觉异常。方差总贡献率为65.73%。

结论

接受放化疗的NPC患者出院后可能会出现持续的不良症状群。护士应在出院前评估患者症状,并提供有针对性的健康教育服务,以减少患者并发症,提高居家生活质量。此外,医护人员应及时、全面地评估并发症,并为受影响患者提供个性化健康教育,以帮助他们应对放化疗副作用。

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