卵巢癌患者癌症相关性认知功能障碍现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2023.14.009

摘要/Abstract

摘要：

目的调查卵巢癌患者癌症相关性认知功能障碍（cancer-related cognition impairment，CRCI）的发生状况，分析其影响因素，并探讨主观与客观认知功能障碍评估的相关性。方法采用方便抽样法，选取2021年5月—2022年2月在上海市某三级甲等肿瘤专科医院日间化疗中心、妇科肿瘤病房及门诊就诊的155例卵巢癌患者作为调查对象，采用一般资料调查表、蒙特利尔认知评估量表及感知缺陷问卷进行调查。结果卵巢癌患者蒙特利尔认知评估量表得分为（24.14±4.02）分，CRCI的发生率为65.8%（102/155），以抽象能力、延迟回忆及视空间与执行功能降低最为显著。感知缺陷问卷得分为（17.35±10.67）分，其中回顾性记忆、规划/组织能力影响最严重。文化程度以及是否复发是卵巢癌患者客观CRCI的影响因素（P<0.05）；文化程度、居住状况、是否有口服药是其主观CRCI的影响因素（P<0.05）。患者感知缺陷问卷得分与蒙特利尔认知评估量表得分呈负相关（r=-0.210，P=0.009）。结论卵巢癌患者CRCI发生率高，建议医护人员将CRCI纳入到卵巢癌患者的常见症状管理中，对于有高危因素者给予循证干预，以提高其生存质量。

关键词: 卵巢癌, 癌症相关性认知功能障碍, 症状评估, 肿瘤护理

Abstract:

Objective To investigate the current situation of cancer-related cognitive impairment（CRCI） in patients with ovarian cancer，analyze its influencing factors，and explore the correlation between subjective and objective assessment of cognitive impairment. Methods From May 2021 to February 2022，155 patients with ovarian cancer from Shanghai Cancer Center were investigated by general information questionnaire，the Montreal Cognitive Assessment Scale（MoCA） and the Perceived Deficit Questionnaire（PDQ）. Results Ovarian cancer patients had a high incidence of CRCI. The average score of MoCA was （24.14±4.02），and the incidence of CRCI was 65.8%. The decrease in abstraction，delayed recall，and visuospatial/executive functions were the most signi-ficant. The average score of PDQ was 17.35±10.67，with retrospective memory and planning/organization dimensions being the most severe. Binary logistics regression analysis showed that education and recurrence were influencing factors of MoCA（P<0.05）. Multiple linear regression analysis showed that education，living status and taking oral medication significantly affected the score of PDQ. The score of PDQ were significantly negatively correlated with the score of MoCA（r=-0.210，P=0.009）. Conclusion The prevalence of CRCI is high in patients with ovarian cancer，mainly in the memory，abstraction，and visual space and executive function. It is recommended that healthcare workers could incorporate CRCI into the symptom management of patients with ovarian cancer，and implement evidence-based interventions to those with high-risk factors to improve their quality of life.

Key words: Ovarian Cancer, Cancer-Related Cognitive Impairment, Symptom Assessment, Oncologic Nursing

王丽英, 丁焱, 张易, 陈雅琼, 薛嵋, 王霞. 卵巢癌患者癌症相关性认知功能障碍现状及影响因素分析[J]. 中华护理杂志, 2023, 58(14): 1726-1732.

WANG Liying, DING Yan, ZHANG Yi, CHEN Yaqiong, XUE Mei, WANG Xia. The status and influencing factors of cancer-related cognitive impairment in patients with ovarian cancer[J]. Chinese Journal of Nursing, 2023, 58(14): 1726-1732.

图/表 4

表1 卵巢癌患者的一般资料及癌症相关性认知功能障碍的单因素分析

Table 1 General data and univariate analysis of CRCI in patients with ovarian cancer

表2 基于蒙特利尔认知评估量表得分的多因素分析（n=155）

Table 2 Multivariate analysis based on MoCA scores（n=155）

表3 基于感知缺陷问卷得分的多因素分析（n=155）

Table 3 Multivariate analysis based on PDQ scores（n=155）

表4 卵巢癌患者感知缺陷评估与蒙特利尔认知评估的相关性分析

Table 4 Analysis of the correlation between PDQ and MoCA in patients with ovarian cancer

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