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探索接受化疗的结直肠癌患者发生财务毒性的潜在特征及影响因素:一项横断面研究

Explore Potential Profiles and Influencing Factors for Financial Toxicity in Patients with Colorectal Cancer Undergoing Chemotherapy: A Cross-Sectional Study.

作者信息

Li Fangyi, Xiao Tian, Liu Chunmei, Ma Qiumei, Huang Xiaoli, Qiu Xueqin, Zhou Linyu, Xiao Ruihan, Chen Xiaoju

机构信息

School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China.

Department of Oncology, Chengdu Seventh People's Hospital, Chengdu, Sichuan, China.

出版信息

Semin Oncol Nurs. 2025 Feb;41(1):151762. doi: 10.1016/j.soncn.2024.151762. Epub 2024 Dec 13.

Abstract

OBJECTIVES

To explore the potential financial toxicity (FT) profiles in patients with colorectal cancer (CRC) undergoing chemotherapy and analyze its influencing factors.

METHODS

A cross-sectional study was conducted on 373 CRC patients undergoing chemotherapy in southwest China from January 2024 to May 2024. We utilized the General Information Questionnaire, the FT based on Patient-Reported Outcome Measures (COST-PROM), the Brief Illness Perception Questionnaire (BIPQ), and the Family APGAR Index (APGAR). Latent profile analysis (LPA) by Mplus8.3 was used to identify the latent profiles of the FT. Multinomial logistic regression analysis was used to analyze the relevant factors in the different categories.

RESULTS

The patients with CRC undergoing chemotherapy were divided into four profiles: high FT group (44.5%), moderate FT-low psychological adaptation group (22.8%), moderate FT-high psychological adaptation group (18.0%), and low FT group (14.7%). Age, average monthly household income per capita, employment status, disease duration, round of chemotherapy, illness perception, and family function were the influencing factors for potential profiles of FT in CRC chemotherapy patients (P < 0.05).

CONCLUSIONS

There are four potential profiles of FT in patients with CRC undergoing chemotherapy. Healthcare providers should pay attention to patients with CRC undergoing chemotherapy aged 18 to 59 years old, employed and unemployed, with lower average monthly household income per capita, disease duration of less than 1 year, and more times of chemotherapy. Additionally, reducing patients' negative perceptions of the disease and improving family function can help lower the level of FT.

IMPLICATION FOR NURSING PRACTICE

This research can assist nurses in identifying patients at high risk of FT, enabling early intervention and the implementation of targeted psychological nursing interventions. Nurses can help patients develop positive perceptions of the disease and improve family relationships, thereby mitigating the negative effects of FT.

摘要

目的

探讨接受化疗的结直肠癌(CRC)患者潜在的财务毒性(FT)特征,并分析其影响因素。

方法

对2024年1月至2024年5月在中国西南部接受化疗的373例CRC患者进行横断面研究。我们使用了一般信息问卷、基于患者报告结局测量的FT(COST-PROM)、简短疾病认知问卷(BIPQ)和家庭APGAR指数(APGAR)。采用Mplus8.3进行潜在类别分析(LPA)以识别FT的潜在类别。使用多项逻辑回归分析来分析不同类别中的相关因素。

结果

接受化疗的CRC患者被分为四类:高FT组(44.5%)、中度FT-低心理适应组(22.8%)、中度FT-高心理适应组(18.0%)和低FT组(14.7%)。年龄、人均家庭月平均收入、就业状况、病程、化疗疗程、疾病认知和家庭功能是CRC化疗患者FT潜在类别的影响因素(P<0.05)。

结论

接受化疗的CRC患者存在四种潜在的FT特征。医疗服务提供者应关注年龄在18至59岁、就业和未就业、人均家庭月平均收入较低、病程小于1年且化疗次数较多的接受化疗的CRC患者。此外,减少患者对疾病的负面认知并改善家庭功能有助于降低FT水平。

对护理实践的启示

本研究可帮助护士识别FT高风险患者,实现早期干预并实施针对性的心理护理干预。护士可帮助患者形成对疾病的积极认知并改善家庭关系,从而减轻FT的负面影响。

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