目的 建立肺癌患者的化疗期间症状网络,为后期制订症状管理计划提供理论依据。方法 便利抽样法选取安徽医科大学第一附属医院于2023年1月至2025年2月收治的205例肺癌患者作为本研究的调查对象,采用一般资料问卷、中文版安德森症状评估量表对其进行问卷调查。数据分析采用探索性因子分析及网络分析。结果 本研究共回收有效问卷194份,有效率为94.63%。肺癌患者化疗期间症状的发生率为11.34%~80.41%。发病率最高的前3个症状分别是咳嗽(80.41%)、恶心(79.38%)与苦恼(76.80%)。严重程度前3位依次是疲劳[(3.88±1.56)分]、悲伤[(3.31±1.63)分]和咳嗽[(3.27±1.58)分]。提取的4个症状群分别为呼吸系统症状群、胃肠道症状群、情绪症状群及神经感知症状群。症状网络分析结果显示,症状间关联强度最高的3对关系依次为:悲伤与疲劳(r=0.76)、呼吸困难与胸闷(r=0.72)及疼痛与麻木(r=0.71)。中心性分析表明,强度中心性最高的症状为悲伤(rs=7.43)、恶心(rs=6.73)和咳嗽(rs=6.65);桥梁中心性分析进一步显示,悲伤在症状网络中均为核心桥梁症状(rs=5.69),提示其在症状群间具有重要的连接作用。结论 肺癌化疗患者存在显著的症状负担,其中悲伤、咳嗽与恶心在多维症状网络中发挥较强作用,需作为核心干预靶点。针对悲伤的干预措施能有效降低整个症状网络的严重程度,而对咳嗽和恶心的早期干预可减轻患者的症状管理负担。
Abstract
Objective To establish a symptom network for lung cancer patients during chemotherapy, providing a theoretical basis for formulating symptom management plans in the later stage. Method A total of 205 lung cancer patients admitted to our hospital from January 2023 to February 2025 were selected as the subjects of this study using the convenience sampling method. General information questionnaires and the Chinese version of the Anderson symptom scale were used to conduct questionnaire surveys on them. Data analysis was carried out through exploratory factor analysis and network analysis. Result A total of 194 valid questionnaires were retrieved in this study, with an effective rate of 94.63%. The incidence of symptoms during chemotherapy in lung cancer patients ranges from 11.34% to 80.41%. The top three symptoms with the highest incidence rates are cough (80.41%), nausea (79.38%), and distress (76.80%). In terms of severity, the top three were fatigue (3.88±1.56), sadness (3.31±1.63), and cough (3.27±1.58) in sequence. Results of symptom network analysis indicated that the top three pairs with the strongest correlation among symptoms were sadness and fatigue (r = 0.76), dyspnea and chest tightness (r = 0.72), as well as pain and numbness (r = 0.71). Centrality analysis indicated that sadness (rs = 7.43), nausea (rs = 6.73), and cough (rs = 6.65) exhibited the highest strength centrality values. Furthermore, betweenness centrality analysis identified sadness as a core bridging symptom (rs = 5.69), suggesting its critical role in connecting distinct symptom clusters. Conclusion Patients with lung cancer undergoing chemotherapy have a significant symptom burden. Sadness, cough, and nausea have a strong effect on the multi-dimensional symptom network and need to be regarded as core intervention targets. Intervention measures for grief can effectively reduce the severity of the entire symptom network, while early intervention for coughing and nausea can alleviate the burden of symptom management for patients.
关键词
肺癌 /
化疗期间 /
症状 /
症状群 /
桥梁症状 /
症状网络
Key words
Lung cancer /
During chemotherapy /
Symptoms /
Symptom cluster /
Bridge symptom /
Symptom network
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基金
2022年度安徽省卫生健康科研项目立项项目(AHWJ2022A001)
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