鼻咽癌患者同步放化疗期间的症状群及影响因素研究

Symptom clusters and influencing factors for patients with nasopharyngeal carcinoma undergoing concurrent chemoradiation therapy

摘要:

目的：探讨鼻咽癌（nasopharyngeal carcinoma，NPC）患者在同步放化疗期间的症状群及其影响因素。方法：采用安德森症状-头颈部量表中文版对235例同步放化疗期间的NPC患者症状群采用探索性因子分析的方法进行横断面调查。结果：2013年6月至2013年11月共235例患者完成了调查，结果显示：NPC患者普遍存在多种症状，其中症状强度最显著的三个症状分别是味觉异常232例（98.7%）、口干230例（98.2%）和口腔/咽喉黏液229例（97.5%）。探索性因子分析得出4个症状群：口腔黏膜相关症状群、胃肠道症状群、病感行为症状群和一般症状群。多元直线回归显示医保类型、是否有医保为最主要的影响因素（P=0.022）。结论：NPC患者存在多个症状，且以集群的现象存在。正确认识症状群有利于医护人员采取针对性的指导干预措施，改善患者症状负担。

Abstract:

Objective：To explore the symptom clusters and influencing factors for patients with nasopharyngeal carcinoma（NPC） un－dergoing concurrent chemoradiation therapy（CCRT）. Methods：A random sample of patients completed the M. D. Anderson symptom inventory-head & neck（MDASI-H&N）. The exploratory factor analysis was conducted to do cross-sectional investigation. Results：A total of 235 patients completed the survey. Varieties of symptoms were generally identified in NPC patients. The most severe symp－toms were dysgeusia，dry mouth and mouth/throat mucus. The exploratory factor analysis of symptoms revealed four major symptom clusters，which were oral mucosa-associated，gastrointestinal，sickness-behavior and general symptom clusters. Predictors on the in－tensity of symptom clusters were medicare type and health insurance according to the results of multiple regression analysis. Conclu－sion：Symptom clusters are identified in NPC patients. Recognition of these symptom clusters can relieve the symptom of patients and is useful for medical staff to assess and provide effective interventions.