食管癌术后辅助化疗患者症状困扰与应对方式的相关性研究

目的了解食管癌术后辅助化疗患者的症状困扰和应对方式现状,并探讨二者之间的相关关系。方法采用M.D.Anderson症状量表和医学应对方式问卷对84例食管癌术后辅助化疗患者进行调查。结果食管癌术后辅助化疗患者症状的发生率为100.00%,89.29%的患者存在症状困扰;患者以面对和回避应对方式为主,但与常模比较,采用回避和屈服应对方式频率较高,面对应对方式频率较低;患者的症状困扰与面对应对呈正相关。结论食管癌术后辅助化疗患者的症状困扰值得关注,且症状困扰与应对方式相互影响,护理工作者应采取措施帮助患者有效应对,减轻症状困扰。     

膀胱癌术后膀胱内灌注化疗患者的症状特征及困扰分析

目的：分析膀胱癌经尿道膀胱肿瘤电切术后患者膀胱灌注化疗期间的症状及其对患者的困扰程度及特点,探讨患者不适症状的个体化干预方法。方法应用自编一般资料调查表、M. D. Anderson症状调查量表及增补条目,对84例膀胱癌术后膀胱灌注化疗患者进行调查分析。个体化干预后观察患者症状的改善情况。结果患者术后膀胱灌注化疗期间的症状分量表平均得分（3.12±1.02）分,属轻度;症状分量表条目得分排序前5位依次是胃口差、疲劳乏力、睡眠不安、恶心、呕吐。困扰分量表平均得分（2.85±2.02）分,属轻度;困扰分量表条目得分从高到低依次为工作、情绪、一般活动、生活乐趣、行走、人际关系。增补条目得分依次是膀胱内烧灼感、膀胱刺激征、胃肠道反应。给予个体化干预后患者部分症状评分明显下降（P〈0.05）。结论膀胱癌经尿道膀胱肿瘤电切术后患者膀胱灌注化疗期间普遍存在症状困扰,提示应根据患者症状困扰的特点进行个体化干预,以缓解其症状困扰。     

结肠癌术中化疗患者症状体验与自我管理效能的相关性研究

目的：了解结肠癌术中化疗患者的症状体验与自我管理效能感水平,并分析两者的关系.方法：采用MD Anderson消化道癌症症状调查量表和中文版癌症自我管理效能感量表对97例结肠癌患者进行调查.结果：结肠癌患者术中化疗症状症状程度最严重的前4项症状依次是疲乏（6.74±2.83）分、疼痛（6.15 ±2.02）分、睡眠不安（5.69±1.53）分、口干（5.30±1.37）分;对患者生活功能造成中度及以上水平困扰,包括患者的一般活动（7.67±1.95）分、走路（6.84±2.14）分、工作（6.32±1.49）分、生活乐趣（5.12±1.37）分.本组患者自我管理效能感处于中等水平（81.68±13.44）分.症状体验各维度与总体自我管理效能感均呈负相关（P＜0.05）.结论：结肠癌术中化疗患者症状体验感较为强烈,护理人员应加强对患者症状的管理与控制,提高患者的自我管理效能感水平,改善其生活质量.     

食管癌术后化疗患者症状困扰对患者焦虑、抑郁的影响

目的探讨食管癌术后化疗患者症状困扰对患者焦虑、抑郁的影响。方法选取经病理切片确诊为食管癌并行食管癌根治术的患者108例,至少经历1个疗程化疗。采用M D Anderson症状调查量表和医院焦虑抑郁量表对患者进行调查。结果患者的症状困扰及生活受干扰评分为3.91和2.91,患者焦虑状态与症状困扰和生活受干扰程度呈正相关,抑郁与生活受干扰程度呈正相关。结论症状困扰在食管癌术后化疗患者中较为普遍,在护理此类患者时,除提供一般性护理措施外,更应关注患者心理状况。     

84例食管癌根治术后患者化疗期间症状特点及其困扰分析

目的描述食管癌根治术后患者化疗期间的症状及其对患者的困扰程度和特点。方法应用自编一般资料调查表、M.D.Anderson症状调查量表及增补条目,对84例食管癌根治术后化疗患者进行调查分析。采用描述性统计法分析症状条目得分水平。结果本组患者症状得分为(3.18±1.49)分,属轻度;症状分量表条目得分排序前5位依次是胃口差、疲劳乏力、睡眠不安、恶心、呕吐。症状困扰得分(2.81±1.82)分,属轻度;困扰分量表条目得分从高到低依次为工作、情绪、一般活动、生活乐趣、行走、与他人关系。增补条目得分排前5位依次是:脱发、体质量减轻、反流、腹泻、胃部不适。结论食管癌根治术后患者化疗期间普遍存在症状困扰,提示应根据患者症状困扰的特点进行个体化干预,以缓解其症状困扰。     

胃癌术后化疗病人疾病不确定感与症状困扰的相关性研究

[目的]探讨胃癌术后化疗病人疾病不确定感与症状困扰之间的关系.[方法]采用横断面调查方法,运用一般资料问卷、Mishel疾病不确定感量表和记忆症状评估量表调查了221例胃癌术后化疗病人,分析疾病不确定感与症状困扰之间的关系.[结果]胃癌术后病人化疗期间疾病不确定感呈中等水平,得分为（90.67±11.87）分;病人普遍存在症状困扰,疾病不确定感水平与症状困扰水平呈正相关.[结论]护理人员应重视胃癌术后化疗病人疾病不确定感和症状的个性化评估,运用症状管理探讨疾病不确定感的有效干预方案.     

食管癌辅助化疗患者症状困扰与应对方式的相关性研究

目的掌握食管癌辅助化疗患者症状困扰与应对方式现状,并分析两者的相关性。方法选择2017年8月—2018年2月本院行根治术治疗+辅助化疗的食管癌患者共90例为对象。采用癌症患者症状自评量表(含症状严重程度和症状困扰程度2个维度)和医学应对方式量表(含面对、回避、屈服3个维度),掌握术后辅助化疗食管癌患者症状困扰和应对方式现状,并对两者进行Pearson相关性分析。结果患者症状严重程度、症状困扰程度得分分别为(3. 36±1. 50)分、(3. 02±1. 67)分。食管癌患者面对、回避与屈服方式得分分别为(18. 23±3. 65)分、(15. 58±3. 34)分、(9. 62±3. 28)分,与常模比较差异均有统计学意义(P 0. 05)。Pearson相关性分析结果表明:食管癌辅助化疗患者面对方式与症状严重程度、症状困扰程度呈正相关(r=0. 276、0. 258,P 0. 05)。结论食管癌辅助化疗患者普遍存在不同程度的症状困扰,并多选择回避和屈服作为应对方式。应对方式与症状严重程度、症状困扰程度相互影响。     

166例胃癌术后化疗患者症状群内前哨症状的调查

目的 探讨胃癌术后化疗患者症状群内前哨症状,比较不同特征胃癌术后化疗患者前哨症状评分上的差异。方法 采用方便抽样方法,选取自2019年1—11月入住江苏省中医院肿瘤内外科病房的胃癌术后化疗患者作为研究对象。采用一般资料调查表、自制症状首次出现记录表及安德森症状评估量表胃癌特异性模块,对其进行调查。采用IBM SPSS Statistic 22.0、IBM SPSS Modeler 18.0进行数据分析。结果 共调查166例胃癌术后患者,疼痛是病感症状群的前哨症状,其首次出现时间为（18.64±23.83）h,疼痛、疲乏支持度为53.0%,置信度为98.9%,疼痛、睡眠不安支持度为53.0%,置信度为60.2%;悲伤是情绪症状群的前哨症状,其首次出现时间为（11.88±8.95）h,悲伤、苦恼支持度为86.5%,置信度为99.1%;消化道症状群、胃癌特异性症状群、神经系统相关性症状群未见明确前哨症状。不同年龄、肿瘤分期、化疗次数、中医证型的胃癌术后化疗患者,其疼痛评分比较,差异均有统计学意义（P<0.05）;不同手术方式、教育程度、肿瘤分期、化疗方案、化疗次数、中医证型的胃癌术后化疗患者,其悲伤评分比较,差异均有统计学意义（P<0.05）。结论 疼痛是病感症状群的前哨症状,悲伤是情绪症状群的前哨症状;50岁以下、肿瘤Ⅳ期、第3次化疗、气滞血瘀证型的胃癌术后化疗患者,其疼痛评分最高;远端胃切除、大专及以上学历、肿瘤Ⅳ期、行伊立替康+氟尿嘧啶+亚叶酸钙化疗方案、第1次化疗及气滞血瘀证型的胃癌术后化疗患者,其悲伤评分最高。医务人员可针对前哨症状进行有针对性的评估及干预,以达到有效管理症状群的目的。     

肺癌患者化疗期间的症状体验及相关因素研究

目的描述肺癌患者化疗期间的症状体验特点,探讨其影响因素.方法运用安德森症状评估量表,便利抽取西安市3家三级甲等医院的123例肺癌化疗患者,调查分析其化疗期间的症状体验及相关因素.结果本组的主要症状依次为:疲乏(6.26±1.62)分、苦恼(4.25±1.88)分、胃口差(4.96±2.07)分、睡眠不安(4.48±2.01)分,发生率均在90%以上;给患者的工作、一般活动、生活乐趣带来较大的困扰,其得分分别是(7.03±1.85)分、(5.42±1.69)分、(4.64±1.60)分.症状体验受在职与否、家庭人均月收入、性别、疾病临床分期4个因素的影响(P<0.05).结论肺癌患者化疗期间症状发生频率均高于50%,处于轻中度水平,受疾病的临床分期、性别等的影响,给患者带来较大的症状困扰.提示临床护士应对肺癌化疗患者进行症状评估,并给予管理和控制.     

乳腺癌患者术前及术后1年期间症状困扰程度的纵向研究

目的探讨乳腺癌患者术前及术后1年期间症状困扰的发生状况及变化规律。方法采用便利抽样法,选取2016年6—7月在广州市某三级甲等肿瘤专科医院就诊,初次经病理学诊断为乳腺癌并在该院进行手术的80例乳腺癌患者作为研究对象。采用M.D.Anderson症状调查量表测量患者术前、术后3个月、术后6个月、术后1年的症状困扰状况。结果乳腺癌患者术前、术后3个月、术后6个月、术后1年的症状分量表得分分别为(1.23±1.04)、(3.20±1.54)、(3.09±1.27)、(1.10±0.69)分,差异有统计学意义(F=97.70,P<0.01),困扰分量表得分分别为(1.49±1.63)、(4.24±2.30)、(3.08±1.86)、(0.98±0.89)分,差异有统计学意义(F=89.01,P<0.01)。乳腺癌患者症状困扰程度于术后3个月时最高,随后逐渐下降,直至术后1年时低于术前水平。结论乳腺癌患者术前至术后1年的症状困扰程度为轻度至中度,患者症状困扰程度于术后3个月最高,随后逐渐下降,直至术后1年时低于术前水平。患者每个时期都存在不同程度的症状困扰问题,这提示我们要有针对性地对患者不同时期因疾病或治疗引起的不良反应进行管理。     

Symptom distress of Jordanian patients with cancer receiving chemotherapy

The purpose of this study was to explore the prevalence of symptom distress among Jordanian patients with cancer who are receiving chemotherapy. A total of 112 patients with cancer were evaluated using the Distress Thermometer and clinical symptom problem list, and Demographic and Clinical Characteristic Data Sheet. Patients in the sample were mostly female, and recently diagnosed with cancer during the past 6 months, with a variety of types of cancer with breast cancer being the most common. Patients reported several symptoms with nausea, fatigue, anorexia and daily activity disorder being reported most frequently. Most of the patients (71%) reported distress at a clinically significant level. Distress was correlated with clinical characteristics as treatment number and time. Problems in the areas of family relationships, emotional functioning and physical functioning were associated with higher reports of distress. Identification of the presence of distress is the first step towards referral and treatment of the symptoms that may contribute to the distress of the patient with cancer.     

乳腺癌患者化疗期间症状体验与自我效能感的纵向研究

目的调查乳腺癌患者在化疗不同时期的症状体验与自我效能感的纵向变化状况,并分析它们之间的关系。方法采用方便抽样法抽取2014年2月-2015年11月确诊为乳腺癌准备进行乳腺癌切除术,接受辅助化疗且符合抽样标准的乳腺癌患者308例作为研究对象,分别在化疗开始前、化疗早期、化疗中期、化疗结束四个时间点,调查其症状体验和自我效能感状况。结果 (1)随着化疗周期的延长,自我效能感总分及各维度得分均呈下降趋势,化疗开始前的自我效能感水平高于化疗结束期(P=0.001),化疗早期高于化疗中期(P=0.003),而化疗开始前和化疗早期、化疗中期和化疗结束两两比较均无明显统计学意义(P0.05)。(2)在化疗早期、中期及化疗后三个阶段症状体验总均分分别为(10.52±0.41)分、(13.40±0.27)分和(17.73±0.35)分。在化疗不同时间段的症状总均分、严重程度、困扰程度之间的差异均有统计学意义(P0.05),随着化疗周期的延长,症状体验水平呈上升趋势。(3)患者在化疗早期、中期和化疗后的症状体验与自我效能感及各维度间呈负相关(P0.05或P0.01)。结论在化疗的不同时期,乳腺癌患者的症状体验与自我效能感水平均存在差异,两者间有一定的相关性,护士应关注此变化特征,选择最佳时机进行干预。     

Discrepancies and similarities in how patients with lung cancer and their professional and family caregivers assess symptom occurrence and symptom distress

Historically, conceptual distinctions have not been made between the components of symptom experience—symptom distress and symptom occurrence—nor has the question of how distressing patients perceive different symptoms to be, irrespective of their current occurrence, been addressed. The aim of this study was to explore the hypothesis that there may be different patterns in discrepancies between how lung cancer patients and their caregivers assess symptom distress and in how they assess symptom occurrence. Thirty-three patient–nurse dyads and 54 patient–family caregiver dyads assessed patients' symptom distress and symptom occurrence. Discrepancies with regard to how patients, nurses, and family caregivers assessed symptom distress and symptom occurrence were identified. Patients and caregivers were more in agreement about which symptoms might cause distress than about current symptom occurrence. Caregivers rated symptom occurrence as greater than patients. The findings highlight the need to further explore what symptom characteristics caregivers address when assessing patients' symptom experiences.     

Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer

Goals of work Although many patients with ovarian cancer achieve favorable responses to primary chemotherapy, the majority of women will experience recurrence of their cancer. Selection of second- or third-line chemotherapy ultimately depends on patient preferences for different side effects. To better understand this process, we evaluated preferences and symptom distress in patients with ovarian cancer.Patients and methods A total of 70 women with ovarian cancer who had previously received at least three cycles of platinum-based chemotherapy and currently undergoing chemotherapy for newly diagnosed or recurrent disease were interviewed in an outpatient chemotherapy clinic. The patients were asked to rank order 27 health states using a modified visual analog scale and to complete the Memorial Symptom Assessment Scale (MSAS).Main results Most favorable health states included perfect health, clinical remission and complete control of chemotherapy-induced nausea and vomiting (CINV). Least favorable health states included more severe CINV health states and death. Patients on first-line chemotherapy had less symptom distress, and rated sexual dysfunction, fatigue and memory loss more favorably than patients on second- or third-line chemotherapy (P<0.05). Married patients generally had less symptom distress compared to patients who were not married, but married patients indicated more distress with sexual dysfunction (P=0.04). Married patients rated alopecia less favorably than unmarried patients (P=0.03), but married patients viewed certain CINV health states more favorably (P=0.02–0.04).Conclusions CINV remains one of the most dreaded side effects of chemotherapy. Separate preference profiles exist for patients with newly diagnosed and recurrent disease, as well as for married versus unmarried patients. While MSAS scores and VAS rankings showed consistency across some health states, this was not true for CINV, suggesting that current symptom status may only influence patient preferences for selected side effects.     

癌症化疗病人睡眠质量与症状困扰、心理状态的相关性研究

[目的]探讨癌症化疗病人住院期间睡眠现状及与化疗期间症状困扰和心理状态的相关性,为癌症化疗病人的临床护理提供参考和指导。[方法]应用一般人口学资料问卷、匹兹堡睡眠质量指数量表、安德森症状评估表（MDASI C）及综合医院焦虑抑郁量表（HADS）对北京市某2所三级甲等医院胸外科、肿瘤科、妇科的95例癌症化疗病人进行调查,并对睡眠质量与症状困扰、心理状态的相关性进行分析。[结果]癌症化疗病人住院期间睡眠质量好者3例（3.2%）,一般16例（16.8%）,差者76例（80.0%）;癌症化疗病人住院期间睡眠质量指数与化疗症状困扰、心理状态呈正相关（P=0.000）。[结论]大多数癌症化疗病人住院期间睡眠质量差,睡眠质量与化疗症状困扰和焦虑抑郁程度呈正相关。临床工作中应考虑症状和心理状态对病人睡眠的影响,有针对性地对病人的睡眠进行健康教育。     

Patterns of symptom distress in adults receiving treatment for lung cancer

Knowledge of the patterns of symptom distress in adults receiving treatment for lung cancer is an important first step in developing interventions that can potentially lessen symptom distress. The purposes of this secondary analysis were to describe the changes in patterns of symptom distress over time in adults receiving treatment for lung cancer, and to examine the relationship of selected demographic and clinical characteristics to symptom distress. Complete data were available for 117 patients. The patterns of symptom distress in adults receiving treatment for lung cancer varied between treatment groups and over time. Symptom distress scores were moderate to high on entry into the study, indicating that symptom management in newly diagnosed lung cancer patients is essential and should begin early in the course of illness. Moreover, clinical interventions should be tailored to the type of treatment. Various demographic and clinical variables were weak and inconsistent predictors of symptom distress, underscoring the importance of examining the role of psychosocial factors in mediating symptom distress.     

Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy

The diagnosis of lung cancer in the advanced stage of illness, the poor prognosis associated with the disease, and the side effects of chemotherapy all have an impact on various dimensions of quality of life (QoL).

The purpose of the research

The current study was designed to describe the QoL and symptom distress of lung cancer patients undergoing chemotherapy and to explore the relationships between demographic/treatment-related characteristics and QoL.

Methods and sample

The sample consisted of 154 lung cancer patients undergoing chemotherapy. The symptom experiences and QoL of lung cancer patients undergoing chemotherapy were evaluated using the Memorial Symptom Assessment Scale and Quality of Life Index – Cancer Version.

Results

The lung cancer patients had low QoL scores. The scores on the Health and Functioning subscale were the lowest (20.33 ± 5.59), while those of the Family subscale were the highest (27.66 ± 2.77). The most common physical symptoms experienced by lung cancer patients were lack of energy, coughing, pain, lack of appetite, and nausea, while the psychological symptoms were feeling nervous, difficulty sleeping, feeling sad, and worrying. There was a negative relationship between the symptom distress and quality of life scores (r = −0.45; p < 0.000). Females and those with low income levels and performance status experienced greater symptom distress.

Conclusions

Lung cancer patients receiving chemotherapy suffer many limitations due to the symptoms and disruptions to their QoL, arising from both the disease process and its treatment. Lung cancer patients need to be assessed regularly and supported.     

Predictors of symptom distress in women with breast cancer during the first chemotherapy cycle.

PURPOSE: To determine the extent to which personal characteristics and "person factors" predict symptom distress during the first cycle of chemotherapy. DESIGN: Prospective, longitudinal, correlational. SAMPLE AND SETTING: 120 women with Stage I and II breast cancer starting their first cycle of chemotherapy were recruited from six diverse oncology settings. METHODS: Self-report questionnaires were completed prior to the beginning, the nadir, and the end of the first chemotherapy cycles. MAIN RESEARCH VARIABLES: Personal characteristics, "person factors", and symptom distress. FINDINGS: Optimism and external locus of control predicted low symptom distress levels at the both the nadir and at the end of the first cycle. Fatigue, appearance, and insomnia caused the greatest distress with higher symptom distress scores reported at the nadir with a mean item score of 1.98 on a five-point Likert scale. CONCLUSIONS: Women who maintained a positive outlook, and trusted their health care providers experienced lower levels of symptom distress. Findings suggest that most women experienced some symptom distress, particularly during the middle of the first cycle of chemotherapy.