[1]杨丽敏,刘佳丽,王亚兰,等.中晚期肺癌患者症状和困扰发生的潜在类别分析[J].军事护理,2023,40(10):61-65.[doi:10.3969/j.issn.2097-1826.2023.10.015]
　YANG Limin,LIU Jiali,WANG Yalan,et al.Symptoms and Distress Among Patients in Advanced Lung Cancer:A Latent Class Analysis[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(10):61-65.[doi:10.3969/j.issn.2097-1826.2023.10.015]
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中晚期肺癌患者症状和困扰发生的潜在类别分析
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年10期
页码:
61-65
栏目:
研究荟萃
出版日期:
2023-10-15

文章信息/Info

Title:
Symptoms and Distress Among Patients in Advanced Lung Cancer:A Latent Class Analysis
文章编号:
2097-1826(2023)10-0061-05
作者:
杨丽敏1; 刘佳丽2; 王亚兰3; 俞娟3; 覃惠英2
(1.贵州医科大学附属医院 护理部,贵州 贵阳 550001; 2.中山大学肿瘤防治中心 护理部,广东 广州 510060; 3.中山大学肿瘤防治中心 内科)
Author(s):
YANG Limin1; LIU Jiali2; WANG Yalan3; YU Juan3; QIN Huiying2
(1.Department of Nursing,Affiliated Hospital of Guizhou Medical University,Guiyang 550001,Guizhou Province,China; 2.School of Nursing,Sun Yat-Sen University,Guangzhou 510080,Guangdong Province,China; 3.Department of Internal Medicine,Sun Yat-Sen University Cancer Center,Guangzhou 510060,Guangdong Province,China)
关键词:
肺癌;  症状体验;  潜在类别分析;  影响因素;  护理
Keywords:
lung cancer;  symptom experience;  latent class analysis;  influencing factor;  nursing care
分类号:
R473.56
DOI:
10.3969/j.issn.2097-1826.2023.10.015
文献标志码:
A
摘要:
目的 探讨中晚期肺癌患者症状体验的潜在类别及相关特征,为实施精准化症状管理干预提供参考。方法 2021年9月至2022年1月,采用便利抽样法选取广州市某三级甲等医院住院治疗的中晚期肺癌患者220例为调查对象。采用一般资料调查表和汉化修订版安德森症状评估量表-肺癌模块对其调查,采用潜在类别分析对中晚期肺癌患者症状体验进行分类,并分析社会人口学资料和疾病资料对症状体验潜在类别的影响。结果 220例中晚期肺癌患者中,症状报告数量为13(7,19)个,症状严重程度得分为1.36(0.64,2.51)分。其症状体验可分为症状低发-困扰低发组(24.6%)、症状中发-困扰中发组(45.0%)、症状高发-困扰高发组(30.4%)。不同类别患者在症状报告数量、症状严重程度和症状困扰程度方面差异均有统计学意义(均P<0.05)。性别、吸烟情况、有无表皮生长因子受体突变和是否接受免疫治疗是中晚期肺癌患者症状体验潜在类别的影响因素(均P<0.05)。结论 中晚期肺癌患者的症状体验存在群体异质性,医护人员应重点关注女性、有吸烟史、有表皮生长因子受体突变、接受免疫治疗患者的症状体验评估和干预。
Abstract:
Objective To explore the potential categories and characteristics of symptom experience of patients with advanced lung cancer,and to provide evidence for implementing precise symptom management.Methods From September 2021 to January 2022,the convenience sampling method was used to select 220 patients with advanced lung cancer in a tertiary hospital in Guangzhou.A survey was conducted by general information questionnaire and Chinese version of the Lung Cancer Module of the MD Anderson Symptom Inventory.Latent class analysis(LCA)was used to identify the potential categories.The multinomial logistic regression was used to analyze the influencing factors of potential categories.Results Among 220 patients with advanced lung cancer,the number of symptom reports was 13(7,19),and the symptom severity score was 1.36(0.64,2.51).The symptom experience could be divided into low incidence of symptom and low incidence of distress(24.6%),moderate incidence of symptom and moderate incidence of distress(45.0%),and high incidence of symptom and high incidence of distress(30.4%).There were statistically significant differences in the number of symptom reports,the severity of symptoms and the degree of symptom distress among different categories of patients(all P<0.05).Gender,smoking,with or without epidermal growth factor receptor mutation and whether to receive immunotherapy were the influencing factors of the potential categories of symptom experience in patients with advanced lung cancer(all P<0.05).Conclusion There is group heterogeneity in symptom experience of patients with advanced lung cancer.Health professionals should pay attention to the evaluation and intervention of symptom experience in patients who are women,former smokers,with epidermal growth factor receptor(EGFR)mutation,and receiving immunotherapy.

参考文献/References:

[1] SUNG H,FERLAY J,SIEGEL R L,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71(3):209-249.
[2] 夏世旺,艾甜甜,李立.非小细胞肺癌放化疗后复发转移的预测模型[J].临床肿瘤学杂志,2018,23(10):920-924.
[3] 颜雯晶,刘艳萍,丁茹蕾,等.肺癌化疗患者疲乏-负性情绪-疼痛-睡眠障碍症状群及其影响因素 [J].解放军护理杂志,2019,36(6):44-47.
[4] ARMSTRONG T S.Symptoms experience:a concept analysis[J].Oncol Nurs Forum,2003,30(4):601-606.
[5] CHEN Z,HE G,ZHAO Y,et al.Symptom burden and emotional distress in advanced lung cancer:the moderating effects of physicians' communication skills and patients' disease understanding[J].Support Care Cancer,2022,30(11):9497-9505.
[6] MIASKOWSKI C,BARSEVICK A,BERGER A,et al.Advancing symptom science through symptom cluster research:expert panel proceedings and recommendations[J/OL].[2023-01-23].https://academic.oup.com/jnci/article/109/4/djw253/2581261?login=true.DOI:10.1093/jnci/djw253.
[7] 王孟成.潜变量建模与Mplus应用:进阶篇[M].重庆:重庆大学出版社,2018:5.
[8] 方积乾.生物医学研究的统计方法[M].2版.北京:高等教育出版社,2019:399-400.
[9] 张立力,臧瑜.MD安德森症状评估量表肺癌模块的修订和考评[J].肿瘤,2013,33(5):434-438.
[10]CHEN Y,WEN S,WU Y,et al.Efficacy and safety of first-generation epidermal growth factor receptor(EGFR)tyrosine kinase inhibitors(TKIs)combined with chemotherapy or antiangiogenic therapy as first-line treatment in patients with EGFR-mutant non-small cell lung cancer:a systematic review and meta-analysis[J/OL].[2023-01-20].https://linkinghub.elsevier.com/retrieve/pii/S1040-8428(21)00181-5.DOI: 10.1016/j.critrevonc.2021.103393.
[11]REMON J,MEZQUITA L,CORRAL J,et al.Immune-related adverse events with immune checkpoint inhibitors in thoracic malignancies: focusing on non-small cell lung cancer patients[J].J Thorac Dis,2018,10(Suppl 13):S1516-S1533.
[12]MIASKOWSKI C,DUNN L,RITCHIE C,et al.Latent class analysis reveals distinct subgroups of patients based on symptom occurrence and demographic and clinical characteristics[J].J Pain Symptom Manage,2015,50(1):28-37.
[13]LIAO J,WANG Y,DAI W,et al.Profiling symptom burden and its influencing factors at discharge for patients undergoing lung cancer surgery:a cross-sectional analysis[J/OL].[2023-01-20].https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-022-01974-9.DOI:10.1186/s13019-022-01974-9.
[14]RECK M,SCHENKER M,LEE K H,et al.Nivolumab plus ipilimumab versus chemotherapy as first-line treatment in advanced non-small-cell lung cancer with high tumour mutational burden:patient-reported outcomes results from the randomised,open-label,phase III CheckMate 227 trial[J].Eur J Cancer,2019,116:137-147.
[15]PAZ-ARES L,LUFT A,VICENTE D,et al.Pembrolizumab plus chemotherapy for squamous non-small-cell lung cancer[J].N Engl J Med,2018,379(21):2040-2051.
[16]HAMMER M J,COOPER B,PAUL S M,et al.Identification of distinct symptom profiles in cancer patients using a pre-specified symptom cluster[J].J Pain Symptom Manage,2022,64(1):17-27.

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备注/Memo

备注/Memo:
【收稿日期】2023-02-23【修回日期】2023-09-12
【基金项目】广东省基础与应用基础研究基金面上项目(2021A1515010718)
【作者简介】杨丽敏,护士,硕士,电话:020-87343292
【通信作者】覃惠英,电话:020-87343292
更新日期/Last Update: 2023-10-15