Abstract:

Objective This study aimed to identify the dynamic changes of symptom clusters（SCs） in the newly diagnosed acute myeloid leukemia（AML） patients at 3 time points during their induction therapy（IT）. Methods A longitudinal study with a convenient sample was conducted among 130 newly diagnosed AML patients in the department of hematology of a tertiary hospital from Jan 2018 to Jun 2020. The Chinese version of the Memorial Symptom Assessment Scale was used to collect data at 3 time points,namely the day before IT（T1）,the last day of IT（T2）,and 7 days after IT（T3）. Exploratory factor analysis was used to identify SCs. Results There were 4 SCs at T1,including psychological SC,nutritional SC,neurological SC and pain-sweating SC. There were 3 SCs appearing at T2,involving gastrointestinal SC,fatigue SC and treatment related SC. Moreover,4 SCs emerged at T3,comprising psychological SC,gastrointestinal SC,fatigue SC and body image SC. Psychological SC was noted at T1 and T3,while fatigue SC and gastrointestinal SC appeared at T2 and remained consistent at T3. Conclusion The changes of SCs,which the newly diagnosed AML patients undergoing the IT experienced,is dynamic. Nurses should prioritize symptom management interventions to focus on the following SCs,namely psychological SC at T1,gastrointestinal SC at T2,and fatigue SC at T3.

Key words: Acute Myeloid Leukemia, Induction Therapy, Symptom Clusters, Longitudinal Study, Nursing Care

摘要：

目的 探讨急性髓系白血病（acute myeloid leukemia,AML）患者诱导缓解治疗（induction therapy,IT）期症状群的变化情况。方法 2018年1月—2020年6月,便利选取山东省某三级甲等医院血液内科首次确诊为AML并接受IT的130例患者,运用中文版记忆症状评估量表在IT开始前1 d（T1）、IT结束当天（T2）、IT结束后第7天（T3）对其进行评估,运用因子分析确立症状群的组成。 结果 T1存在4个症状群,为心理症状群、营养症状群、神经症状群和疼痛-出汗症状群。T2存在3个症状群,为胃肠道症状群、疲乏症状群和治疗相关症状群。T3存在4个症状群,为心理症状群、胃肠道症状群、疲乏症状群和形象改变症状群。其中心理症状群在T1和T3存在,疲乏症状群和胃肠道症状群在T2和T3持续存在。结论 AML患者在IT期经历的症状群呈动态变化。IT前的心理症状群、IT中的胃肠道症状群、IT结束后的疲乏症状群可作为优先干预的症状群。

关键词: 急性髓系白血病, 诱导缓解治疗, 症状群, 纵向研究, 护理