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症状群及其对中国肺癌患者生活质量的影响:一项横断面研究。

Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study.

机构信息

Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China.

Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.

出版信息

Eur J Oncol Nurs. 2023 Dec;67:102465. doi: 10.1016/j.ejon.2023.102465. Epub 2023 Nov 7.

Abstract

PURPOSE

To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning.

METHOD

A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis.

RESULTS

Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (β = -0.60, P = 0.02) and fatigue-related symptom cluster (β = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (β = -1.68, P < 0.01), role (β = -1.63, P < 0.01) and cognitive functioning (β = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (β = -1.26, P < 0.01); and the psychoneurological (β = -0.81, P < 0.01) and gastrointestinal symptom cluster (β = -0.60, P = 0.05) predicted social functioning.

CONCLUSIONS

Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.

摘要

目的

调查中国肺癌患者的症状群,并探讨其对生活质量(QoL)及其各功能的影响。

方法

2022 年 10 月至 2023 年 4 月,在四川省一家综合医院对 219 例肺癌患者进行了横断面研究。使用一般信息问卷、MD 安德森症状量表和 EORTC QLQ-C30 收集数据。R 软件在 RStudio 平台上进行描述性统计、探索性因子分析和多元回归分析。

结果

确定了心理神经、呼吸、胃肠道和疲劳相关的症状群,每个症状群与整体 QoL、总体健康状况/QoL 和每个功能均呈显著负相关。呼吸(β=-0.60,P=0.02)和疲劳相关的症状群(β=-0.86,P=0.02)是总体健康状况/QoL 的预测因子;疲劳相关的症状群预测身体(β=-1.68,P<0.01)、角色(β=-1.63,P<0.01)和认知功能(β=-1.45,P<0.01);心理神经症状群是患者情绪功能的预测因子(β=-1.26,P<0.01);心理神经(β=-0.81,P<0.01)和胃肠道症状群(β=-0.60,P=0.05)预测社会功能。

结论

呼吸和疲劳相关的症状群是总体健康状况/QoL 的强预测因子;疲劳相关、心理神经和胃肠道症状群对患者的功能有负面影响。执业护士应更加关注监测呼吸和疲劳相关的症状群,及时识别高危人群,并根据症状群进行针对性干预,协同减轻症状负担,从而提高患者的 QoL。

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