摘要
目的探讨中老年妇科恶性肿瘤患者围手术期症状群的构成及变化轨迹,为制订症状管理方案提供参考。方法采用便利抽样法,选取2022年12月—2023年9月就诊于新疆医科大学附属肿瘤医院行手术治疗的中老年妇科恶性肿瘤患者145例为研究对象。采用一般资料调查问卷、中文版安德森症状系列量表-妇科恶性肿瘤围手术期模块分别于术前1d(T1)、术后第1天(T2)、术后第3天(T3)和术后第7天(T4,即出院前)4个时间点对患者进行纵向调查。结果本研究共发放问卷145份,回收有效问卷130份,问卷有效回收率为89.66%(130/145)。探索性因子分析共提取出6个症状群,分别是围绝经期症状群、心理症状群、疲乏-疼痛症状群、消化道症状群、能量不足症状群和手术相关症状群。其中围绝经期症状群是妇科恶性肿瘤患者特异性症状群,存在于T1;心理症状群在患者围手术期间持续存在;疲乏-疼痛症状群和手术相关症状群存在于T2~T4;消化道症状群和能量不足症状群存在于T2、T3。结论中老年妇科恶性肿瘤患者围手术期存在多种症状,在不同时间节点上的症状可聚集成群,症状群数目随着手术治疗的开展而增多,而群内核心症状随时间的推移相对稳定。因此,临床护理人员要重视患者围手术期症状群的动态变化,根据症状群的变化轨迹,采取高效、有针对性的管理措施,减轻患者围手术期症状负担。
Objective To explore the composition and trajectory of symptom clusters during perioperative period in middle-aged and elderly patients with gynecological malignant tumors,so as to provide reference for formulating symptom management programs.Methods From December 2022 to September 2023,convenience sampling was used to select 145 middle-aged and elderly patients with gynecological malignant tumors who underwent surgical treatment at the Affiliated Cancer Hospital of Xinjiang Medical University as the study subject.A longitudinal survey was conducted on patients at four time points[1 day before surgery(T1),1 day after surgery(T2),3 days after surgery(T3),and 7 days after surgery(T4,before discharge)using the General Information Questionnaire and the Chinese version of the Anderson Symptom Inventory-Perioperative Module in Patients with Gynecological Cancer.Results A total of 145 questionnaires were distributed,and 130 valid questionnaires were collected,with an effective response rate of 89.66%(130/145).Exploratory factor analysis extracted six symptom clusters,namely perimenopausal symptom cluster,psychological symptom cluster,fatigue-pain symptom cluster,gastrointestinal symptom cluster,energy deficiency symptom cluster,and surgery related symptom cluster.Perimenopausal symptom group was a specific symptom cluster of gynecological malignant tumor patients,existing at T1.Psychological symptom cluster persisted during the patient's perioperative period.Fatigue-pain symptom cluster and surgery related symptom cluster existed at T2 to T4.Gastrointestinal symptom cluster and energy deficiency symptom cluster existed at T2 and T3.Conclusions Middle aged and elderly patients with gynecological malignant tumors have various symptoms during the perioperative period,and the symptoms can cluster at different time points.The number of symptom clusters increases with the progress of surgical treatment,while the core symptoms within the cluster remain relatively stable over time.Clinical nursing staff should pay attention to
作者
崔秀云
徐春艳
赵静
宿晶
袁菁
张佳
Cui Xiuyun;Xu Chunyan;Zhao Jing;Su Jing;Yuan Jing;Zhang Jia(School of Nursing,Xinjiang Medical University,Urumqi 83001l,China;Department of Gynecological Surgery,Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《中华现代护理杂志》
2024年第17期2323-2329,共7页
Chinese Journal of Modern Nursing
基金
省部共建中亚高发病成因与防治国家重点实验室护理学专项(SKL-HIDCA-2023-HL13)
“天山英才”医药卫生高层次人才培养计划(TSYC202301B161)。
关键词
围手术期
恶性肿瘤
中老年
妇科
纵向研究
症状群
症状管理
Perioperative period
Neoplasms
Middle aged and elderly
Department of Gynecology
Longitudinal studies
Syndrome
Symptom management
