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Objective:To establish a questionnaire to assess symptom of embolization syndrome after transcatheter hepatic arterial chemoembolization (TACE) in patients with liver cancer, so as to provide a tool of assessing and managing symptom management after TACE.Methods:From March 2020 to June 2021, through literature review, qualitative interview and Delphi expert consultation, the first draft of symptom assessment questionnaire for TACE post-operative embolism syndrome was prepared. The reliability and validity of the questionnaire were tested in 200 patients with liver cancer treated by TACE in department of Liver Oncology, Zhongshan Hospital affiliated to Fudan University.Results:According to the feedback from Delphi expert consultation a draft questionnaire with 9 items of physiological symptoms and 6 items of psychological and social symptoms was formed. Item analysis showed that each item in the questionnaire had a good degree of differentiation. There was significant correlation between each item and the total score of the questionnaire. Three factors were extracted by exploratory factor analysis, naming psychosocial symptom group as factor 1, somatic discomfort symptom group as factor 2 and gastrointestinal reaction symptom group as factor 3, and the cumulative variance contribution rate was 62.592%. Spearman correlation coefficient between this questionnaire and the Anderson Symptom Assessment Scale was 0.855( P<0.05). The Cronbach α of the total questionnaire was 0.898, and. The Cronbach α of the three factors were 0.885, 0.771 and 0.870 respectively. Conclusions:The symptom assessment questionnaire of embolization syndrome after TACE in liver cancer patients prepared in this study has good reliability and validity, which can provide an evaluation basis for the symptom management of TACE.
ABSTRACT
Purpose@#Symptom experience after liver transplantation (LT) provides healthcare professionals with important information about the benefits and limitations of LT from patients’ perspective. This study aims to explore the multidimensional symptom experience and analyze related predictive factors in LT recipients. @*Methods@#This cross-sectional study evaluated the occurrence, frequency, intensity, and level of distress of 40 symptoms in 265 LT recipients. Stepwise multiple regression analysis was performed to analyze the influencing factors of symptom experience. @*Results@#The analysis of patient-reported data indicated that the ten most common symptoms were fatigue (42.3%), frequent sleep interruptions (38.9%), difficulty falling asleep (35.9%), decreased memory (34.0%), dreaminess (29.8%), itch (28.7%), muscular weakness (26.4%), shortness of breath (25.3%), anxiety (24.5%), and hand tremor (21.9%). Patients were classified into four groups according to survival time (1-month, 2–6-month, 7–12-month, and >1-year groups) after LT, and the most common symptom was fatigue in the one-month and 2–6-month groups, difficulty falling asleep in the 7–12-month group, and decreased memory in the >1-year group. Type of the primary caregiver, complications, concerns about the decreased ability to perform household and outdoor activities, and concerns about being a burden to the family were predictors of symptoms burden. @*Conclusion@#LT recipients experienced complicated symptoms. In clinical practice, it is critical to integrate physicians, nurses, and social workers as a medical team to help LT recipients develop suitable coping strategies that can potentially address patients’ concerns, increase the sense of confidence, and improve symptom outcomes.
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Purpose@#Symptom experience after liver transplantation (LT) provides healthcare professionals with important information about the benefits and limitations of LT from patients’ perspective. This study aims to explore the multidimensional symptom experience and analyze related predictive factors in LT recipients. @*Methods@#This cross-sectional study evaluated the occurrence, frequency, intensity, and level of distress of 40 symptoms in 265 LT recipients. Stepwise multiple regression analysis was performed to analyze the influencing factors of symptom experience. @*Results@#The analysis of patient-reported data indicated that the ten most common symptoms were fatigue (42.3%), frequent sleep interruptions (38.9%), difficulty falling asleep (35.9%), decreased memory (34.0%), dreaminess (29.8%), itch (28.7%), muscular weakness (26.4%), shortness of breath (25.3%), anxiety (24.5%), and hand tremor (21.9%). Patients were classified into four groups according to survival time (1-month, 2–6-month, 7–12-month, and >1-year groups) after LT, and the most common symptom was fatigue in the one-month and 2–6-month groups, difficulty falling asleep in the 7–12-month group, and decreased memory in the >1-year group. Type of the primary caregiver, complications, concerns about the decreased ability to perform household and outdoor activities, and concerns about being a burden to the family were predictors of symptoms burden. @*Conclusion@#LT recipients experienced complicated symptoms. In clinical practice, it is critical to integrate physicians, nurses, and social workers as a medical team to help LT recipients develop suitable coping strategies that can potentially address patients’ concerns, increase the sense of confidence, and improve symptom outcomes.
ABSTRACT
Objective:To study the correlation between fatigue symptoms and living condition of liver transplant recipients after discharge from hospital, so as to provide reference basis for preventing postoperative fatigue symptoms in recipients.Methods:From September 2018 to December 2018, 280 liver transplant recipients were selected from the liver transplantation clinic of a grade-three hospital in Shanghai by convenience sampling method, and clinical data of the patients were obtained by questionnaire survey to analyze factors of the symptom of postoperative fatigue.Results:A total of 280 patients were included, among which 130 patients showed fatigue symptoms, accounting for 46.4%. The results of single-factor analysis showed that the postoperative survival days, gender, total time of exercise, body mass index, working status, mode of payment of medical expenses, Sleep quality, negative emotions, and nutritional risk all exert an influence on fatigue symptoms ( P<0.05). The results of multi-factor analysis showed that the total time of exercise during a week ( OR=0.674, 95% CI:0.512-0.887), postoperative survival days ( OR=0.993, 95% CI:0.989-0.997) and the score of negative emotion scale ( OR=1.484, 95% CI:1.157-1.902) had significant influence on fatigue symptoms in patients ( P<0.01). Conclusions:Postoperative survival days, exercise time and negative emotions are the main factors affecting fatigue symptoms. Medical staff should evaluate and manage patients' psychological and activity exercise to improve fatigue symptoms.