摘要
目的探讨多发性骨髓瘤患者化疗不同时间症状群的构成及动态变化,运用症状网络探索群内症状之间的关系,为症状管理提供依据。方法便利选取175例初诊多发性骨髓瘤患者为研究对象,采用一般资料调查表和中文版记忆症状量表于患者诱导化疗前,化疗第1、2、3、4疗程结束后1周进行调查。应用探索性因子分析提取症状群,运用R语言构建症状网络,分析中心性指标。结果多发性骨髓瘤化疗不同时间共提取4个常见症状群:心理症状群、疾病行为症状群、疲乏相关症状群、消化道症状群;化疗前到化疗1、2、3疗程间歇期担忧是最主要的核心症状,第4疗程间歇期忧伤为最主要的核心症状,均属于心理症状群。结论不同时期的症状群相对稳定,又呈动态变化。医护人员需对稳定存在的症状群及核心症状进行全程干预,提高症状管理的精准度和效率,改善患者的症状负担。
Objective To investigate the components and dynamic changes of symptom clusters in patients with multiple myeloma during chemotherapy cycles,and to explore the relationships between symptoms within clusters through symptom network,so as to provide evidence for symptom management.Methods A convenience sample of 175 patients newly diagnosed with multiple myeloma were recruited and surveyed using a general information questionnaire and the Chinese version of Memorial Symptom Assessment Scale before induction chemotherapy and at completion of the 1st to 4th cycle of chemotherapy.Exploratory factor analysis was performed to extract symptom clusters.R software was used to construct symptom networks and analyze centrality measures.Results Four common symptom clusters were identified at different chemotherapy cycles:psychological,disease behavior,fatigue related,and digestive tract.The most central symptom was worry during pre-chemotherapy stage and during the intermittent pe-riod of the first three cycles of chemotherapy,and was distress during the intermittent period of the 4th cycle.Both of the above two symptoms were in the psychological symptom cluster.Conclusion The symptom clusters are relatively stable during different che-motherapy cycles and also exhibit dynamic changes.Medical staff need to conduct interventions on those stable symptom clusters and central symptoms,so as to improve the accuracy and efficiency of symptom management,and to alleviate symptom burden of patients.
作者
杜慧慧
焦倩
刘超
杨便红
吴雪
郭俊艳
李婷婷
Du Huihui;Jiao Qian;Liu Chao;Yang Bian hong;Wu Xue;Guo Junyan;Li Tingting(Nursing Department,Peking University International Hospital,Beijing 102206,China)
出处
《护理学杂志》
CSCD
北大核心
2024年第21期29-34,共6页
Journal of Nursing Science
基金
国家自然科学基金面上项目(72071004)
北京大学国际医院院内护理科研专项基金(YN2023HL03)。
关键词
多发性骨髓瘤
化疗
症状群
疲乏
担忧
忧伤
症状网络
纵向研究
multiple myeloma
chemotherapy
symptom clusters
fatigue
worry
distress
symptom network
longitudinal study
