目的 探讨宫颈癌患者预后营养指数及身心症状群(多维疲劳、广泛焦虑、情绪调节困难)的发展变化趋势,并分析其相关及预测关系。方法 便利抽样的方法选取2024年1月至2024年6月南通市肿瘤医院妇科162例宫颈癌患者为研究对象,分别于首次化疗(T1)、第2次化疗(T2)、末次化疗(T3)对其预后营养指数及身心症状群进行追踪调查,重复测量方差分析、交叉滞后模型用于统计检验。结果 本研究共回收有效问卷152份(回收率93.83%),年龄37~77岁,平均(56.38±6.94)岁。重复测量方差分析结果显示:3个时间点的预后营养指数得分(F=3.352,P=0.035)、多维疲劳得分(F=5.360,P＜0.001)、广泛焦虑得分(F=6.001,P＜0.001)、情绪调节困难得分(F=0.883,P=0.415)。交叉滞后模型结果显示:预后营养指数能够显著预测当下及下一节点的身心症状群;预后营养指数水平平均显著负向预测下一节点的多维疲劳症状(T1→T2:β=-0.416,P=0.003,T2→T3:β=-0.442,P=0.006),预后营养指数水平平均显著负向预测下一节点的广泛焦虑症状(T1→T2:β=-0.373,P=0.008,T2→T3:β=-0.358,P=0.011),T2预后营养指数水平显著负向预测T3情绪调节困难症状(T1→T2:β=-0.161,P=0.147,T2→T3:β=-0.242,P=0.024),而身心症状群中仅有多维疲劳症状平均显著负向预测下一节点的预后营养指数(T1→T2:β=-0.331,P=0.007,T2→T3:β=-0.359,P=0.001)。结论 宫颈癌患者化疗期间预后营养指数与其身心症状群中密切相关,预后营养指数对身心症状群具有负向预测作用,多维疲劳症状对预后营养指数同样具有负性预测作用。
Abstract
Objective To explore the development and change trends of prognostic nutritional index and physical and mental symptom clusters (multidimensional fatigue, generalized anxiety, and difficulty in emotional regulation) in patients with cervical cancer, and to analyze their correlations and predictive relationships. Method A total of 162 patients with cervical cancer were selected as the research subjects by the convenience sampling method. The prognostic nutritional index and physical and mental symptom clusters of them were followed up and investigated respectively during the first chemotherapy (T1), the second chemotherapy (T2), and the last chemotherapy (T3). Repeated measures analysis of variance and cross-lag model were used for statistical tests. Result A total of 152 valid questionnaires were retrieved in this study (recovery rate 93.83%), aged 37 to 77 years, with an average age of (56.38±6.94) years. The repeated measurement results showed that the prognostic nutritional index scores (F=3.352, P=0.035), multi-dimensional fatigue scores (F=5.360, P＜0.001), generalized anxiety scores (F=6.001, P < 0.001), and difficulty in emotion regulation scores (F=0.883, P=0.415) at the three time points. Results of the cross-lag model: The average prognostic nutritional index level significantly and negatively predicted multi-dimensional fatigue symptoms at the next node (T1→T2:β=-0.416,P=0.003,T2→T3:β=-0.442,P=0.006), and the average prognostic nutritional index level significantly and negatively predicted generalized anxiety symptoms at the next node (T1→T2:β=-0.373,P=0.008,T2→T3:β=-0.358,P=0.011), the prognostic nutritional index level of T2 significantly negatively predicted the symptoms of difficult emotion regulation in T3 (T1→T2:β=-0.161,P=0.147,T2→T3:β=-0.242,P=0.024), while among the psychosomatic symptom groups, only multi-dimensional fatigue symptoms significantly and negatively predicted the prognostic nutritional index of the next node on average (T1→T2:β=-0.331,P=0.007,T2→T3:β=-0.359,P=0.001). Conclusion The prognostic nutritional index of patients with cervical cancer during chemotherapy is closely related to their physical and mental symptom clusters. The prognostic nutritional index has a negative predictive effect on the physical and mental symptom clusters, and multi-dimensional fatigue symptoms also have a negative predictive effect on the prognostic nutritional index.
关键词
宫颈癌 /
预后营养指数 /
身心症状群 /
多维疲劳 /
广泛焦虑 /
情绪调节困难 /
相关性 /
交叉滞后模型
Key words
Cervical cancer /
Prognostic nutritional index /
Physical and mental symptom clusters /
Multi-dimensional fatigue /
Widespread anxiety /
Difficulty in emotional regulation /
Correlation /
Cross-lag model
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