Grouping characteristics and predictive indexes of psychological symptoms in patients with non-small cell lung cancer during programmed cell death protein 1 monoclonal antibody combined with chemotherapy / 中国实用护理杂志

ABSTRACT

Objective:To investigate the grouping characteristics of psychological state symptom clusters in patients with non-small cell lung cancer during programmed death 1 (PD-1) monoclonal antibody combined with chemotherapy, and to analyze the predictors of different symptom cluster characteristics.Methods:This study was a cross-sectional study. In the form of a questionnaire, 171 patients with non-small cell lung cancer who received PD-1 monoclonal antibody combined with chemotherapy in Gansu Wuwei Tumor Hospital from March 2019 to March 2021 were selected as the research object by convenient sampling method. The general data questionnaire, Pittsburgh Sleep Quality Index, Cancer-Related Fatigue Survey Scale, Hospital Anxiety and Depression Scale, Physical Activity Measurement Scale for Cancer Patients, Distress Thermometer, and Quality of Life Measurement Scale for Lung Cancer Patients were used for investigation. The latent class model was fitted based on the evaluation results of physical fatigue, anxiety, depression, sleep quality and psychological distress in patients with non-small cell lung cancer during treatment. Latent class model analysis was performed on the scale results to establish a category group model. Logistic regression analysis was used to compare the demographic characteristics, disease stage, classification, and personality characteristics of patients in each group, and to explore the predictive indicators between different categories.Results:According to the symptoms of fatigue, anxiety, depression, sleep disorder and psychological distress in patients with non-small cell lung cancer during PD-1 monoclonal antibody therapy combined with chemotherapy, they were divided into two different categories. The group with high psychological symptoms accounted for 44.44% (76/171) and the group with low psychological symptoms accounted for 55.56% (95/171). The scores of physiological status, social/family status, emotional status, functional status, additional attention and physical activity in the quality of life scale of lung cancer patients with low psychological symptoms were 11.28 ± 5.62, 17.57 ± 4.31, 11.14 ± 3.27, 14.83 ± 5.24, 14.76 ± 4.03 and 88.61 ± 17.38, respectively. The scores were higher than those in the high psychological symptom group 17.82 ± 4.43, 10.76 ± 3.63, 18.62 ± 6.06, 9.34 ± 3.13, 26.26 ± 3.23, 58.04 ± 15.41, the differences were statistically significant ( t values were 10.36-15.84, all P<0.05); logistic regression analysis showed that personality traits [extroverted ( OR=0.08, 95 % CI 0.03-0.23, P<0.05), intermediate ( OR=0.16, 95 % CI 0.08-0.33, P<0.05)] and physical activity in cancer patients ( OR=0.91, 95 % CI 0.88-0.93, P<0.05) were predictors for distinguishing high psychological symptom group. Conclusions:There are obvious classification characteristics of psychological symptom clusters in patients with non-small cell lung cancer during PD-1 monoclonal antibody combined with chemotherapy. Different psychological interventions and nursing care are given according to different psychological symptom characteristics during treatment to improve the quality of life of patients.