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中华妇幼临床医学杂志(电子版) ›› 2012, Vol. 08 ›› Issue (06) : 735 -739. doi: 10.3877/cma.j.issn.1673-5250.2012.06.016

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论著

妇科化疗患者症状体验相关因素分析及对策
冯希源1, 罗碧如1,*,*()   
  1. 1. 610041 成都,四川大学华西第二医院
  • 收稿日期:2012-06-17 修回日期:2012-11-02 出版日期:2012-12-01
  • 通信作者: 罗碧如

Influential Factors and Countermeasures of Symptom Experience of Gynecologic Patients Undergoing Chemotherapy

Xi-yuan FENG1, Bi-ru LUO1()   

  1. 1. Department of Nursing, West China Second University Hospital, Chengdu 610041, Sichuan Province, China
  • Received:2012-06-17 Revised:2012-11-02 Published:2012-12-01
  • Corresponding author: Bi-ru LUO
  • About author:
    (Corresponding author: LUO Bi-ru, Email: )
引用本文:

冯希源, 罗碧如. 妇科化疗患者症状体验相关因素分析及对策[J]. 中华妇幼临床医学杂志(电子版), 2012, 08(06): 735-739.

Xi-yuan FENG, Bi-ru LUO. Influential Factors and Countermeasures of Symptom Experience of Gynecologic Patients Undergoing Chemotherapy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2012, 08(06): 735-739.

目的

了解妇科恶性肿瘤患者在化疗期间的症状体验特点,分析其影响因素,并提出护理对策。

方法

采用方便抽样法(convenience sampling),于2011年10月至2012年1月在成都市某三甲医院接受化疗的110例妇科恶性肿瘤患者进行问卷调查,应用《患者一般资料调查表》(本研究自行设计)、《记忆症状评估量表》(MSAS)、《医院焦虑抑郁量表》(HADS)对其进行调查(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意)。

结果

妇科化疗患者的症状体验总发生率居前5位的为脱发、缺乏活力/乏力、恶心、疼痛、睡眠质量低;频繁程度居前5位依次为:睡眠质量低、缺乏活力/乏力、手脚麻木或刺痛、恶心、食欲差;严重程度居前5位依次为:脱发、睡眠质量低、缺乏活力/乏力、疼痛、恶心;对患者产生的困扰程度居前5位依次为:脱发、便秘、呕吐、睡眠质量低、皮肤改变。本组调查结果显示,患者症状的总发生率、频繁程度、严重程度及困扰程度的前5位存在不一致性,但某些症状(脱发、睡眠质量低、恶心等)的发生率、严重程度、困扰程度均较高。MSAS总分为(1.82±0.74)分,多因素研究结果显示:焦虑、化疗疗程、化疗方案是症状体验的影响因素(P<0.01)。

结论

妇科化疗患者症状体验感较为严重,妇科护理工作者应对其进行有效评估,针对患者症状体验的影响因素,采取相应的护理干预和健康教育消除或缓解症状体验感,提高患者的生存质量。

Objective

To investigate the characteristics of symptom experience of the gynecologic cancer patients undergoing chemotherapy and its influencing factors.

Methods

From October 2011 to January 2012, a total of 110 gynecologic cancer patients undergoing chemotherapy were investigated with the Memorial Symptom Assessment Scale(MSAS), Hospital Anxiety and Depression Scale(HADS). Informed consent was obtained from all participates.

Results

During chemotherapy, gynecologic cancer patients experienced many symptoms including hair loss, lack of energy, nausea, pain, poor sleep, etc.. Those symptoms had higher incidence rates, occurred more frequently and seriously, and brought much more distress to gynecologic cancer patients than other symptoms.The total MSAS score was (1.82±0.74) score. And multi-factor analysis showed that the anxiety, chemotherapy course and chemotherapy regime exerted influence on the symptom experience (P<0.01).

Conclusions

Gynecologic cancer patients undergoing chemotherapy experienced more severe symptoms, so nurses should carry out effective evaluation according to patients' symptom experience, and take corresponding nursing interventions and health education to eliminate or alleviate the patients' symptoms experience, so as to improve the patients' quality of life.

表1 妇科化疗患者症状体验发生情况(n=104)
Table 1 The state of symptom experience of the gynecologic cancer patients undergoing chemotherapy (n=104)
项目 总发生率 频繁程度 严重程度 困扰程度
n(%) 排序 n(%) 排序 n(%) 排序 n(%) 排序
脱发 86(82.70) ? 74(71.15) 55(52.88)
缺乏活力/乏力 82(78.80) 18(17.31) 41(39.42) 10 (9.62)
恶心 79(76.00) 13(12.50) 37(35.58) 12(11.54)
疼痛(腰、腹等) 77(74.00) 5 (4.81) ? 38(36.50) 8(7.69) ?
睡眠质量低 76(73.10) 23(22.10) 50(48.08) 13(12.50)
便秘 76(73.10) ? 37(35.58) 15(14.42)
出汗 74(71.15) 4 (3.80) ? 34(32.69) 10 (9.62) ?
口干 72(69.20) 9 (8.70) 29(27.88) 6 (5.77) ?
食欲差 65(62.50) 13(12.50) 34(32.69) 9 (8.65) ?
焦虑不安 60(57.70) 7 (6.70) 28(26.92) ? 7 (6.70) ?
急躁易怒 58(55.80) ? 9 (8.70) 27(25.96) ? 9 (8.65) ?
口味改变 57(54.80) ? ? 17(16.35) ? 6 (5.77) ?
精神紧张 56(53.80) ? 10(9.62) 33(31.73) 10 (9.62)
呕吐 54(51.90) ? 9 (8.65) 26(25.00) ? 14(13.46)
皮肤改变 54(51.90) ? ? 24(23.08) ? 13(12.50)
昏昏欲睡 51(49.00) ? 6 (5.80) ? 27(25.96) ? 2 (1.92) ?
感到"我看起不像自己" 51(49.00) ? ? 25(24.04) ? 11(10.58)
手脚麻木或刺痛 50(48.08) ? 17(16.30) 27(25.96) ? 11(10.58)
难以集中注意力 49(47.10) ? 6 (5.77) ? 18(17.30) ? 8 (7.69) ?
感到悲伤 47(45.20) ? 7 (6.70) ? 25(24.04) ? 9 (8.65) ?
口腔溃疡 42(40.40) ? ? 20(19.23) ? 7 (6.70) ?
眩晕 38(36.50) ? 3 (2.88) ? 18(17.31) ? 1 (0.96) ?
腹胀 35(33.70) ? 4 (3.80) ? 8 (7.69) ? 3 (2.88) ?
咳嗽 35(33.70) ? 2 (1.90) ? 7 (6.70) ? 0 (0.00) ?
皮肤瘙痒 34(32.69) ? 3 (2.90) ? 15(14.42) ? 3 (2.88) ?
对性生活失去兴趣/性生活困难 32(30.80) ? 6 (5.80) ? 14(13.46) ? 3 (2.88) ?
手臂或腿部肿胀 25(24.04) ? ? 10 (9.62) ? 2 (1.92) ?
腹泻 25(24.00) ? 3 (2.90) ? 12(11.54) ? 5 (4.81) ?
体重下降 24(23.08) ? ? 11(10.58) ? 1 (0.96) ?
呼吸困难 23(22.10) ? 2 (1.92) ? 6 (5.77) ? 1 (0.96) ?
排尿困难 18(17.30) ? 5 (4.81) ? 5 (4.81) ? 3 (2.88) ?
吞咽困难 14(13.46) ? 1 (0.96) ? 6 (5.77) ? 0 (0.00) ?
表2 年龄、住院次数等指标与MSAS评分的相关性分析(n=104)
Table 2 Correlation of the age, number of hospital days and other items and MSAS (n=104)
表3 妇科化疗患者症状体验的单因素分析(n=104)
Table 3 Single factor analysis of the gynecologic cancer patients undergoing chemotherapy (n=104)
表4 妇科化疗患者症状体验的多因素分析(n=104)
Table 4 Multi-factor analysis of the gynecologic cancer patients undergoing chemotherapy (n=104)
[1]
Rhodes VA, McDaniel RW, Homan SS, et al. An instrument to measure symptom experience. Symptom occurrence and symptom distress[J]. Cancer Nurs, 2000, 23(1):49-54.
[2]
Kurt S, Unsar S. Assessment of symptom control in patients with cancer in Northwestern Turkey[J]. Eur J Oncol Nurs, 2011, 15(2):137-144.
[3]
Zucca AC, Boyes AW, Linden W, et al. All's well that ends well? Quality of life and physical symptom clusters in long-term cancer survivors across cancer types[J]. J Pain Symptom Manage, 2012, 43(4):720-731.
[4]
Zigmond AS, Snaith RP. The hospital anxiety and depression scale[J]. Acta Psychiatr Scand, 1983, 67(6):361-370.
[5]
Liu W, Lu HJ, Hu Y, et al. Anxiety and depression among patients with acute myocardial infarction: The predictive factors[J]. J Nurs Sci, 2011, 26(1):70-73.
[6]
Pinar G, Okdem S, Buyukgonenc L, et al. The relationship between social support and the level of anxiety, depression, and quality of life of turkish women with gynecologic cancer[J]. Cancer Nurs, 2012, 35(3):229-235.
[7]
Cheng KK, Wong EM, Ling WM, et al. Measuring the symptom experience of Chinese cancer patients: A validation of the Chinese version of the memorial symptom assessment scale[J]. J Pain Symptom Manage, 2009, 37(1):44-57.
[8]
Zheng CH, Zhang MF, Liu K. Symptom experience in patients with gynecologic malignancies during chemotherapy[J]. J Nurs Sci, 2010, 25(4):24-27.
[9]
Deshields TL, Potter P, Olsen S, et al. Documenting the symptom experience of cancer patients[J]. J Support Oncol, 2011, 9(6):216-223.
[10]
Agarwal S, Bodurka DC. Symptom research in gynecologic oncology: A review of available measurement tools[J]. Gynecol Oncol, 2010, 119(2):384-389.
[11]
Howren MB, Suls J. The symptom perception hypothesis revised: Depression and anxiety play different roles in concurrent and retrospective physical symptom reporting[J]. J Pers Soc Psychol, 2011, 100(1):182-195.
[12]
Wu J. Symptom experience and the related factors in gastric cancer patients afterradical gastrectomy during chemotherapy[D]. Guangzhou:Zhongshan Univ, 2010.
[13]
Walker LM, Bischoff TF, Robinson JW. Supportive expressive group therapy for women with advanced ovarian cancer[J]. Int J Group Psychother, 2010, 60(3):407-427.
[14]
Hua J. Longitudinal study of symptom distress with adjuvant chemotherapy in colon cancer[D]. Shanghai:Fudan Univ, 2010.
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