乳腺癌内分泌治疗患者的同期症状网络分析

doi:10.3761/j.issn.1672-9234.2024.09.018

摘要/Abstract

摘要：

目的调查乳腺癌内分泌治疗患者症状困扰的发生情况及症状困扰程度，构建同期症状网络，以识别核心症状及症状群，为精准化症状管理提供参考。方法采用便利抽样法选取保定市某三级甲等医院2023年2月—11月门诊及肿瘤内科日间病房的乳腺癌内分泌治疗患者，共纳入330例。采用中文版乳腺癌预防试验症状量表（the Chinese Breast Cancer Prevention Trial Symptom Scale，C-BCPT）对患者进行症状评估，运用主成分分析法提取症状群，通过R语言构建症状网络，并计算中心性指标。结果困扰发生率超过50%的症状是疲倦（60.0%）、体重增加（60.0%）、潮热（60.0%）、关节疼痛（52.1%）；提取了认知/疲乏、肌肉骨骼/血管舒缩、性问题3个症状群；在症状网络中，强度最大的症状是不易集中精神（rS=1.09），认知/疲乏症状群的平均强度最大（rS=0.92）；桥梁强度前3位症状为疲倦（rBS=0.29）、体重增加（rBS=0.23）、对性缺乏兴趣（rBS=0.22）。结论乳腺癌内分泌治疗患者存在多种症状，不易集中精神是患者最核心的症状，认知/疲乏症状群为核心症状群，疲倦、体重增加、对性缺乏兴趣是网络分析中的桥梁症状。医护人员可针对核心症状和症状群及桥梁症状制订精准化的干预措施，提高症状管理效能，改善症状管理结局。

关键词: 乳腺癌, 内分泌治疗, 症状网络, 核心症状, 桥梁症状, 症状管理

Abstract:

Objective To investigate the incidence and the degree of symptom distress in breast cancer patients undergoing endocrine therapy，and to construct a contemporaneous symptom network to identify the core symptoms and symptom clusters，so as to provide references for precise symptom management. Methods A convenience sampling method was used to select breast cancer patients undergoing endocrine therapy in outpatient clinics and day wards of a tertiary hospital in Baoding City from February 2023 to November 2023，and a total of 330 patients were included. The Chinese Breast Cancer Prevention Trial Symptom Scale（C-BCPT） was used to assess the symptoms of the patients. The principal component analysis was used to extract the symptom clusters，and the symptom network was construct by R language，and the centrality index was calculated. Results Symptoms that distressed more than 50% of patients were fatigue （60.0%），weight gain （60.0%），hot flashes（60.0%），and joint pain（52.1%），which were also the top four symptoms with the highest degree of distress. Cognitive/fatigue symptom cluster，musculoskeletal/vasomotor symptom cluster，and sexual problems symptom cluster were extracted. In the symptom network，difficult to concentrate（rS=1.09） was a symptom with the highest strength，cognitive/fatigue symptom cluster（rS=0.92） was a symptom cluster with the highest average strength，and the top three symptoms with the highest bridge strength were fatigue（rBS=0.29），weight gain（rBS=0.23），and lack of interest in sex（rBS=0.22）. Conclusion There are various symptoms in breast cancer patients undergoing endocrine therapy. Difficulty in concentration is the core symptom for breast cancer patients，the cognitive/fatigue symptom cluster is the core symptom cluster，fatigue，weight gain，and lack of interest in sex are the bridge symptoms in the network analysis. Healthcare professionals can develop precise interventions for the core symptoms，symptom clusters and bridge symptoms so as to improve symptom management efficiency and outcomes.

Key words: Breast cancer, Endocrine therapy, Symptom network, Core symptoms, Bridge symptoms, Symptom management

和晓歌, 李欢溪, 路潜, 刘春蕾, 柯桑桑. 乳腺癌内分泌治疗患者的同期症状网络分析[J]. 中华护理教育, 2024, 21(9): 1141-1146.

HE Xiaoge, LI Huanxi, LU Qian, LIU Chunlei, KE Sangsang. Contemporaneous symptom network analysis in breast cancer patients undergoing endocrine therapy[J]. Chinese Journal of Nursing Education, 2024, 21(9): 1141-1146.

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