肺癌患者化疗相关症状群的发生现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2023.18.008

摘要/Abstract

摘要：

目的了解肺癌患者化疗相关症状群的发生现状及其潜在类别，并比较各类别患者在社会、疾病、生理和行为4个方面的差异，分析潜在类别的影响因素。方法采用便利抽样法，选取2020年10月—2021年11月在广州市某三级甲等医院就诊的肺癌化疗患者作为调查对象。采用一般资料调查表、国际体力活动问卷-短卷、锻炼自我效能量表、简明疼痛量表、简明疲乏量表、阿森斯失眠量表、患者健康问卷-抑郁筛查量表收集资料。采用Mplus 8.3软件进行潜在类别分析，并应用SPSS 25.0软件进行单因素和Logistic回归分析，确定潜在类别的影响因素。结果回收有效问卷294份，有效问卷回收率为91.88%，其中84.4%的肺癌患者存在化疗相关症状群。潜在类别分析结果显示，存在高症状组（53.6%）和低症状组（46.4%）2个类别。Logistic回归分析结果显示，工作状况、BMI、体力活动水平、锻炼自我效能量表得分、确诊时间和白蛋白浓度是肺癌患者化疗相关症状群潜在类别的影响因素。结论肺癌患者化疗相关症状群的发生率较高，症状特征存在异质性，可分为2个潜在类别。无业、BMI<18.5以及每周体力活动水平、锻炼自我效能、白蛋白浓度较低的患者出现相关症状的概率较大。

关键词: 肺癌, 化疗, 症状群, 横断面研究, 潜在类别分析, 护理

Abstract:

Objective To explore the current status and latent classes of the chemotherapy related symptom cluster of lung cancer patients，and to analyze the differences in 4 aspects of society，disease，physiology and behavior among different classes. Methods Through convenience sampling，lung cancer patients undergoing chemotherapy were recruited from a tertiary hospital in Guangzhou from October 2020 to November 2021. Basic Information Questionnaire，International Physical Activity Questionnaire-Short Form，Exercise Self-Efficacy Scale，Chinese Version of Brief Fatigue Inventory，Athens Insomnia Scale，Chinese Version of Brief Pain Inventory and Patient Health Questionnaire-9 were used for investigation. Exploratory latent class analysis（LCA） was performed by Mplus 8.3. SPSS 25.0 was applied for univariate analysis and logistic regression to identify the factors influencing the latent classes. Results 294 effective questionnaires were collected，and the effective recovery rate was 91.88%. There were 84.4% of lung cancer patients with chemotherapy related symptom cluster，which could be divided into a “high symptom group”（53.6%） and a “low symptom group”（46.4%） by latent class analysis. Logistic regression analysis showed that work status，BMI，physical activity，exercise self-efficacy，time of diagnosis and albumin were the influencing factors of latent classes of symptom cluster in lung cancer patients undergoing chemotherapy. Conclusion The chemotherapy related symptom cluster of lung cancer patients are heterogeneous and can be divided into 2 latent classes. Patients who are unemployed，have the BMI<18.5，and have low physical activity，exercise self-efficacy，and albumin levels are more likely to be in the “high symptom group”.

Key words: Lung Cancer, Chemotherapy, Symptom Cluster, Cross-Sectional Studies, Latent Class Analysis, Nursing Care

叶艳欣, 秦岚, 骆佳慧, 曾凯, 刘素婷, 于雅, 梁静文, 张立力. 肺癌患者化疗相关症状群的发生现状及影响因素分析[J]. 中华护理杂志, 2023, 58(18): 2230-2237.

YE Yanxin, QIN Lan, LUO Jiahui, ZENG Kai, LIU Suting, YU Ya, LIANG Jingwen, ZHANG Lili. Study on status and influencing factors of chemotherapy related symptom cluster among lung cancer patients[J]. Chinese Journal of Nursing, 2023, 58(18): 2230-2237.

图/表 5

表1 肺癌患者化疗相关症状群的潜在类别模型拟合结果（n=248）

Table 1 Model fit results of LCA for chemotherapy related symptom cluster in lung cancer patients（n=248）

图1 肺癌患者化疗相关症状群2个潜在类别的特征分布

Figure 1 Distribution of 2 latent classes of chemotherapy related symptom cluster in lung cancer patients

表2 肺癌患者化疗相关症状群潜在类别的单因素分析（n=248）

Table 2 Univariate analysis of latent classes of chemotherapy related symptom cluster in lung cancer patients（n=248）

表3 自变量赋值表

Table 3 Assignment of independent variables table

表4 肺癌患者化疗相关症状群潜在类别的Logistic回归分析结果（n=248）

Table 4 Logistic regression model of latent classes of chemotherapy related symptom cluster in lung cancer patients（n=248）

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