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Objective:To investigate the symptom clusters and influencing factors among breast cancer patients receiving aromatase inhibitor treatment and to provide a theoretical basis for the symptom clusters management.Methods:From April 2020 to January 2021, 253 breast cancer patients were recruited in Peking University Cancer Hospital by convenient sampling method. All the patients were cross-sectional investigated by the demographic and clinical characteristics questionnaire, the M.D. Anderson Symptom Inventory, the Hospital Anxiety and Depression Scale. The principal component analysis was used to extract the symptom clusters and the multiple linear regression was used to analyze the risk factors.Results:During the period of breast cancer patients receiving aromatase inhibitor treatment, three symptom clusters were identified: sick symptom cluster, treatment related-psychological symptom cluster, digestive symptoms cluster. The prevalence of the three symptom clusters was 49.4%(125/253), 45.1%(114/253), 22.5%(57/253), respectively. The median severity of the three symptom clusters was 2.80, 2.00, 0.67, respectively. Multiple linear regression analysis showed that anxiety and education level were the influencing factors of sick symptom cluster ( β=0.25, -0.25, all P<0.05), anxiety, depression and educational level were the influencing factors of treatment related-psychological symptom cluster ( β = 0.34, 0.20, -0.16, all P<0.05), anxiety, depression and chemotherapy history were the influencing factors of digestive symptom cluster ( β= 0.17, 0.18, -0.13, all P<0.05). Conclusions:Breast cancer patients with aromatase inhibitor treatment are affected by symptom clusters. In order to relieve the symptom clusters, we need pay attention to the mentation, the education level and prerious treatment of the patients.
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Objective To explore the relationship between brain injury related symptom groups and acute stress disorder( ASD). Methods Totally 301 patients with brain injury hospitalized in the Affiliated Hospital of North China University of Technology from March 2017 to March 2018 were recruited. The pa-tients were assessed by Stanford Acute Stress Response Questionnaire ( SASRQ), Brain Trauma Subscale (BIS) and Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of acute stress disorder pa-tients with brain injury was 46. 51% (140/301). The SASRQ score of all patients with brain injury was (70. 78±28. 00). Univariate analysis showed that there were significant differences in age (χ2= 4. 172,P=0. 041),personality type (χ2= 57. 281,P<0. 001),sleep quality ( χ2= 70. 785,P<0. 001),hospitalization frequency (χ2= 43. 547,P<0. 001),depression,obsessive-compulsive and hostile symptoms between pa-tients with and without ASD ( P<0. 05). The scores of depression and obsessive-compulsive symptoms were significantly correlated with SASRQ scores(P<0. 05). The scores of hostility symptoms were significantly cor-related with SASRQ scores except for patients who lost their temper uncontrollably ( r=0. 176-0. 698,P<0. 05). Personality ( OR=0. 243,95% CI=0. 142-0. 415),sleep disorders( OR=0. 072,95% CI=0. 029-0. 178),hospitalization times(OR=0. 129,95%CI=0. 054-0. 306),depressive symptoms( OR=1. 260,95% CI=1. 061-1. 497),obsessive-compulsive symptoms(OR=1. 419,95%CI=1. 239-1. 625) and hostile symp-toms(OR=1. 253,95%CI=1. 058-1. 482) were the influencing factors of ASD in patients with brain injury (P<0. 05). Conclusion The incidence of ASD is higher in patients with brain injury. Personality type,hos-pitalization,sleep quality,depressive symptoms,obsessive-compulsive symptoms and hostile symptoms are the influencing factors,which should be paid more attention.
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Objective To explore the clinical symptom clusters in breast cancer patients with anthracycline treatment, which could provide evidence for prevention. Methods The M.D.Anderson Symptom Inventory of Chinese version (MDASI-C) was applied to assess clinical symptoms in 506 breast cancer patients received anthracycline therapy during their 1stto 4thcycle chemotherapy.Thirteen symptoms were analyzed using main-component analysis and variance orthogonal rotation. The exploratory factor analysis was conducted to find factors value greater than 1. Results The number of symptoms with incidence rate more than 50% was 5, 6, 7 and 9 during the 1stto the 4thcycle, respectively. Fatigue, poor appetite, and nausea were the most common symptoms, and the incidence of these symptoms were 92.5% to 97.1% ,84.8% to 95.1% and 81.1% to 91.3% with the increasing cycle of chemotherapy.Three factors value greater than 1 were detected during the 1stto 2ndcycle chemotherapy by exploratory factor analysis.The cumulative variance contribution rates were 63.233% and 61.434% in the 1stand 2ndcycle, respectively. The main symptom clusters concentrate on fatigue and digestive tract symptoms, including fatigue, sleep disturbance, hypersomnia, nausea, vomit, poor appetite, dry mouth. Two factors value greater than 1 were detected during 3rdto4thcycle in chemotherapy. The cumulative variance contribution rates were 62.660% and 61.148% in the 3rdand 4thcycle, respectively. The main symptom clusters concentrate on psychological and nervous system symptoms including sadness, pain, dry mouth, numbness, hypersomnia, shortness of breath, amnesia and so on. The Cronbach α of cluster symptoms from the 1stto the 4thcycle chemotherapy was between 0.829 to 0.911. Conclusions Symptom clusters vary with the cycles of chemotherapy in breast cancer patients treated with anthracycline. Nurses should provide targeted intervention measures to improve symptom and enhance quality of life, according to specific situation.
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There are different symptom clusters among lung cancer patients, influenced by physical, psychological and treatment factors, which may even threaten patients′ life. In this study, we reveal the survey results of symptom clusters among lung cancer patients through both qualitative research and quantitative research to provide theoretical basis for the practice of nursing intervention, so that we can further relieve patients′symptom burden and improve their life quality.
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The hepatocellular carcinoma (HCC) is one of the most common malignant tumors.Patients with hepatobiliary cancer suffer from multiple symptoms,such as physical symptoms and psychology symptoms.In recent years,along with the further research of symptoms,the concept of symptom clusters occurred.Those two issues have always been the hot topics in recent years.Through the efforts of experts at home and abroad,there has been a part of progress in this area.However,the results are not the same.There are lots of disputes in the numbers、sequence、incidences of the symptom clusters.The paper will discuss this issue from symptom experience and symptom clusters in order to provide the reference and basis for symptom management.