目的 识别乳腺癌术后化疗患者症状群,探索症状群间的桥梁症状,为症状的精准干预及护理提供参考依据.方法 2022 年 10 月—2023 年 10 月,采用便利抽样法,选择本市某三级甲等专科医院 340 例乳腺癌术后化疗患者,采用安德森症状评估量表(MD Anderson symptom inventory,MDASI)、乳腺癌患者生活质量量表(function assessment of cancer therapy breast,FACT-B)进行横断面研究.采用聚类分析法提取症状群,分层回归分析各症状群对生活质量的影响,应用网络分析法识别症状群间的桥梁症状.结果 共 327 例乳腺癌术后化疗患者完成研究.共提取 3 个症状群:消化道症状群、精神心理症状群及神经相关症状群,其中消化道症状群可独立解释生活质量总变异的 10.2%.网络分析中桥梁预期影响系数、强度及紧密中心性指标高的症状为苦恼(rbe=3.927,rbs=3.927,rbc=0.436),疲乏(rbe=3.907,rbs=3.907,rbc=0.434),胃口差(rbe=3.842,rbs=3.842,rbc=0.427).结论 消化道症状群对患者生活质量影响最大;疲乏、胃口差、苦恼是乳腺癌术后化疗患者症状群间的桥梁症状,医护人员可基于桥梁症状对患者进行精准干预,以便提高症状管理效能,节约医疗成本.
Symptom clusters and the bridge symptoms in breast cancer patients undergoing postoperative chemotherapy:a network-based cross-sectional analysis
Objective To identify symptom clusters in breast cancer patients undergoing chemotherapy and investigate the bridge symptoms that connect the symptom clusters,therefore to provide a guidance for precise intervention in the symptoms.Methods From October 2022 to October 2023,convenience sampling method was employed to selelct 340 breast cancer patients,who underwent postoperative chemotherapy,for investigation in the related symptom clusters and quality of life by using Anderson symptom assessment scale and breast cancer quality of life scale.Cluster analysis was performed to extract the symptom clusters by R software and the impacts of each symptom cluster on quality of life were analysed by stratified regression.A contemporaneous symptom network was constructed to identify the bridge symptoms.Results All 327 patients had completed the study.Three distinct symptom clusters were extracted:-gastrointestinal,psychological and neurological symptom clusters.The gastrointestinal cluster alone accounted for 10.2%of the variation in quality of life.Network analysis highlighted that distress(rbe=3.927,rbs=3.927,rbc=0.436),fatigue(rbe=3.907,rbs=3.907,rbc=0.434)and lack of appetite(rbe=3.842,rbs=3.842,rbc=0.427)were the bridging symptoms which had high expected influence coefficient,strength and closeness centrality index.Conclusion The gastrointestinal symptom cluster makes notably impact on the quality of life in breast cancer patients undergoing chemotherapy.Fatigue,lack of appetite and distress are the bridge symptoms in symptom management strategies in potentially improving the efficiency of intervention and reducing the costs to patient.
breast cancerchemotherapysymptom clusterbridge symptomsnetwork analysiscross-sectional study
万方数据
维普
