目的 分析恶性淋巴瘤患者化学治疗(简称化疗)期间症状、症状群构成及动态变化轨迹,为后期制定淋巴瘤患者化疗期间症状管理策略提供依据。方法 采用便利抽样法选取2022年3月至2024年6月于南京医科大学第一附属医院行化学性药物治疗的淋巴瘤化疗患者作为调查对象,采用基本信息调查问卷、中文版安德森症状测评量表、症状补充问卷在化疗期间的4个时间点[首次化疗(T1)、第2次化疗(T2)、第3次化疗(T3)、末次化疗(T4)]分别进行测量。采用探索性因子分析提取症状群。结果 化疗期间4个时间节点的症状发生率大于20%的数目分别为15、17、18、20个。症状发生率13.51%~53.23%。探索性因子分析结果:化疗期间的4个时间点的症状群个数分别为4、5、5、6个,累积方差贡献率为68.253%、65.337%、62.428%、58.615%。症状群变化轨迹结果显示:消化道症状群、认知相关症状群、睡眠障碍症状群、情绪心理症状群持续存在于T1~T4,疼痛症状群存在于T2~T4,活动耐力症状群存在于T4。结论 恶性淋巴瘤患者化疗期间症状高发,T1~T4时间节点症状呈现上升趋势。提示临床工作人员,重视淋巴瘤患者化疗期间的症状的评估、监测和管理,尤其重视化疗结束患者的症状管理,对降低患者症状发生率及严重程度、提高化疗效果意义重大。未来的研究应侧重于针对常见症状制定有针对性的干预措施,以促进患者康复并改善预后。
Abstract
Objective To analyze the symptoms, symptom clusters composition and dynamic change trajectory of lymphoma patients during chemotherapy, and to provide a basis for the later development of symptom management strategies for lymphoma patients during chemotherapy. Methods A convenient sampling method was used to select lymphoma chemotherapy patients who were treated with chemical drugs in the First Affiliated Hospital of Nanjing Medical University from March 2022 to June 2024 as the investigation objects, and the basic information questionnaire, the Chinese version of Anderson symptom assessment scale and symptom supplement questionnaire were used to measure at four time points during chemotherapy. Symptom clusters were extracted by exploratory factor analysis. Results The numbers of symptom incidence greater than 20% at the 4 time nodes during chemotherapy were 15, 17, 18, and 20, respectively. The symptom incidence ranged from 13.51% to 53.23%. Results of exploratory factor analysis: the number of symptom clusters at the 4 time points during chemotherapy were 4, 5, 5, and 6, respectively, with cumulative variance contributions of 68.253%, 65.337%, 62.428%, and 58.615%. The results of symptom cluster change trajectory showed that the digestive symptom cluster, cognitive-related symptom cluster, sleep disturbance symptom cluster, and psychoneurological symptom cluster persisted in T1-T4, the pain symptom cluster existed in T2-T4, and the activity tolerance symptom cluster existed in T4. Conclusion Lymphoma patients have a high prevalence of symptoms during chemotherapy, and the symptoms of the time nodes of T1-T4 showed a rising trend. It suggests that clinical staff should pay attention to the assessment, monitoring and management of symptoms during chemotherapy in lymphoma patients, especially to the management of symptoms in patients who have finished chemotherapy, which is of great significance to reduce the incidence and severity of symptoms and improve the effect of chemotherapy. Future studies should focus on developing targeted interventions for common symptoms to promote patient recovery and improve prognosis.
关键词
恶性淋巴瘤 /
化疗期间 /
症状负担 /
症状群 /
轨迹 /
纵向研究
Key words
lymphoma /
during chemotherapy /
symptom burden /
symptom clusters /
trajectory /
longitudinal study
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