中国医学科学院学报2025，Vol.47Issue(6)：931-938,8.DOI:10.3881/j.issn.1000-503X.16609
肺癌患者放射治疗前及放射治疗结束时症状群及前哨症状特点
Characteristics of Symptom Clusters and Sentinel Symptoms in Lung Cancer Patients Before and at the Completion of Radiotherapy
摘要
Abstract
Objective To investigate the characteristics of symptom clusters and sentinel symptoms in lung cancer patients before and at the completion of radiotherapy,thus providing a theoretical basis for targeted symptom management.Methods A convenience sampling method was used to recruit patients from the Depart-ment of Radiotherapy at Yunnan Cancer Hospital between January and October 2024.A general information ques-tionnaire and the Anderson symptom inventory-lung cancer module(revised)were employed for data collec-tion.The exploratory factor analysis was performed for the symptoms with an incidence rate greater than 20%one day before and at the completion of radiotherapy to identify symptom clusters at different time points.The Apriori algorithm was then adopted to model the associations among symptoms within each cluster and to identify the sen-tinel symptoms.Results A total of 244 patients were included in this study.Three symptom clusters existed be-fore radiotherapy:psychological symptom cluster(sadness,distress,and sleep disorder),lung cancer-related respiratory symptom cluster(cough,expectoration,chest tightness,and shortness of breath),and perception symptom cluster(pain and numbness).Distress and cough were the sentinel symptoms of psychological symptom cluster and lung cancer related respiratory symptom cluster,respectively.At the end of radiotherapy,the psycho-logical symptom cluster and lung cancer-related respiratory symptom cluster remained unchanged.The radiothera-py side effect symptom cluster(dry mouth,pain,loss of appetite)appeared,and the perception symptom clus-ter expanded to encompass 5 items(amnesia,drowsiness,fatigue,nausea,and constipation).Pain and drowsiness were the sentinel symptoms of radiotherapy side effect symptom cluster and perception symptom clus-ter,respectively.Conclusions There are several symptom clusters in lung cancer patients before and at the completion of radiotherapy,and sentinel symptoms exist in symptom clusters at different periods.Nurses can take sentinel symptoms as the intervention targets to formulate effective and targeted nursing measures and reduce the incidence or severity of other symptoms in the cluster,thus diminishing the whole symptom cluster and reducing the burden of patients'symptoms.关键词
肺癌/放射治疗/症状群/前哨症状Key words
lung cancer/radiotherapy/symptom clusters/sentinel symptoms分类
医药卫生引用本文复制引用
ZHANG Jiang,ZHAO Xijuan,YANG Bingkun,YU Shenpin,FEI Yanyan,WU Jiang..肺癌患者放射治疗前及放射治疗结束时症状群及前哨症状特点[J].中国医学科学院学报,2025,47(6):931-938,8.基金项目
中华护理学会科研课题(ZHKYQ202312)和云南省教育厅科学研究基金(2023Y0757、2024J0363) （ZHKYQ202312）
