Abstract:

Objective To explore the time-varying pattern of potential symptoms in breast cancer patient before and after chemotherapy，and further analyze its influencing factors，aims to provide reference for clinical nursing practice. Methods 233 cases of breast cancer in a tertiary A hospital in Ningxia from June to October，2023 were selected as the research subjects. By the general information questionnaire and the Chinese version of Anderson Symptom Assessment Scale，the potential change of symptoms of breast cancer patients undergoing chemotherapy 1-3 days before the first chemotherapy（T1，233 cases） and 7-14 days after the third or fourth chemotherapy（T2，225 cases） was analyzed. Results 225 cases of breast cancer patients completed 2 surveys，and their symptom characteristics before and after chemotherapy can be divided into 2 categories：a high symptom troubled group and a low symptom troubled group. The high-symptom troubled group has strong stability，and the probability of maintaining the original group is 85.20%，while the low-symptom troubled group is more inclined to change to the high-symptom troubled group，and the transition probability is 26.60%. Logistic regression analysis showed that the mass was located on the left side，and the patients who obtained disease knowledge mainly through the Internet were more likely to change from the high symptom troubled group to the low symptom troubled group，while the patients who were employed，with unsatisfactory sleep at night，and never exercised were more likely to change from the low symptom troubled group to the high symptom troubled group. Conclusion The symptoms of breast cancer patients before and after chemotherapy are heterogeneous. Patients who are on the job，have unsatisfied sleep at night and never exercise are more likely to change from the low-symptom troubled group to the high-symptom troubled group，which suggests that medical staff should identify potential high-risk groups at an early stage，and make full use of the predictive function of symptom characteristics to carry out individualized management based on the dynamic monitoring of symptoms according to different types of population characteristics，so as to reduce the burden of symptoms and improve their quality of life.

Key words: Breast Cancer, Postoperative Chemotherapy, Latent Profile Analysis, Latent Transition Analysis, Root Cause Analysis, Nursing Care

摘要：

目的 探讨乳腺癌患者化疗前后症状潜在类别随时间变化趋势并进一步分析其影响因素，旨在为临床护理实践提供借鉴。方法 采取便利抽样法，选取2023年6月—10月在宁夏回族自治区某三级甲等医院就诊的233例乳腺癌患者为调查对象，采用一般资料调查表、中文版安德森症状评估量表，对首次化疗前1~3 d（化疗前，233例），第3次或第4次化疗后7~14 d（化疗后，225例）的乳腺癌患者症状特征进行潜在转变分析。结果 225例乳腺癌患者完成2次调查，化疗前后其症状特征可分为高症状困扰组、低症状困扰组2个类别。高症状困扰组稳定性强，保持原组的概率为85.20%。低症状困扰组更倾向于向高症状困扰组转变，转变概率为26.60%。Logistic回归分析显示，包块部位在左侧、获取疾病知识最主要途径为网络的患者更容易从高症状困扰组转变为低症状困扰组，而在职、夜间睡眠不满意及从不运动的患者更容易从低症状困扰组转变为高症状困扰组。结论 乳腺癌患者化疗前后的症状特征存在人群异质性，在职、夜间睡眠不满意及从不运动的乳腺癌患者更容易从低症状困扰组转变为高症状困扰组，提示医护人员早期识别潜在高风险人群，根据不同类别的人群特征实施症状动态监测的基础上，充分运用症状特征的预测作用进行个体化管理，从而减轻症状负担，提高其生活质量。

关键词: 乳腺癌, 术后化疗, 潜在剖面分析, 潜在转变分析, 影响因素分析, 护理