首页> 中文期刊> 《中华现代护理杂志》 >鼻咽癌放疗患者症状与生活质量相关性的纵向研究

鼻咽癌放疗患者症状与生活质量相关性的纵向研究

摘要

Objective To describe the change of symptoms and quality of life among nasopharyngeal carcinoma patients who undergo radiotherapy, and analyze the correlation between them.Methods A total of 218 nasopharyngeal carcinoma patients who received radiotherapy were included by convenient sampling method and they were asked to finish the questionnaire of general information, Chinese Version of the M.D. Anderson Symptom Inventory(MDASI-C) and Quality of Life Instruments for Cancer Patients-Head and Neck (QLICP-HN) at five time points, which were beginning, intermediate (the volume of radiotherapy at 36-40 Gy), end of radiotherapy, three months and six months after radiotherapy.Results The severity of symptoms at five time points were (1.86±1.75),(3.20±1.75),(3.59±1.81),(0.65±0.59) and (0.52±0.50), presenting decreased gradually first, and then alleviated. The score of symptom severity at five time points were significantly different (F=182.86,P<0.05). Fatigue, appetite loss and dry mouth were the most sever and high-incidence symptoms during and within six months after radiotherapy. The quality scores of life were (65.39±10.90),(58.78±8.77),(57.82±9.20),(79.76±5.75) and( 76.79±4.78) at five time points, representing the same trend as the scores of symptom, and the difference were statistically significan(t F=129.75,P< 0.05). Spearman correlation analysissuggested that there were negative correlation between severity of symptoms and total score of quality of life (P < 0.05). Conclusions The symptoms of nasopharyngeal carcinoma patients exacerbates with dose of radiotherapy increase, and the quality of life is also decreased. Although most of symptoms disappear within six months after radiotherapy, fatigue, appetite loss and dry mouth persisted and influence patients' quality of life.Nurses should pay attention to patients' symptoms when they stay at hospital as well as discharged, and intervention is necessary to improve their quality of life.%目的 描述鼻咽癌放疗患者放疗期间及放疗后症状严重程度及生活质量的纵向变化,并分析症状严重程度与生活质量的相关性.方法 采用便利抽样法,选取2014年5月—2016年4月病理确诊为鼻咽癌并在浙江省肿瘤医院接受放射治疗的初诊患者218例,采用一般资料调查表、中文版安德森症状评估量表(MDASI-C)、头颈肿瘤患者生命质量测定量表(QLICP-HN)在患者放疗前、放疗中(放疗剂量在36~40 Gy)、放疗结束时、放疗后3个月、放疗后6个月共5个时间点对其进行调查.结果 鼻咽癌患者放疗前、中、后、结束后3个月、6个月症状严重程度平均得分分别为(1.86±1.75)、(3.20±1.75)、(3.59±1.81)、(0.65±0.59)、(0.52±0.50)分,呈先逐渐加重、后减轻的趋势,5个时间点的症状得分差异具有统计学意义(F=182.86,P<0.05).疲劳、食欲下降、口干是放疗期间及放疗结束后6个月内发生率最高且最严重的症状.5个时间点患者生活质量得分分别为(65.39±10.90)、(58.78±8.77)、(57.82±9.20)、(79.76±5.75)、(76.79±4.78)分,呈先降低、后升高的趋势,差异具有统计学意义(F=129.75,P<0.05).Spearman相关分析显示,5个时间点患者症状严重程度与生活质量总分均呈负相关关系(P<0.05).结论 随着放射治疗的进行,鼻咽癌患者各症状均逐渐加重,生活质量也随之降低,放疗结束后半年内,患者的多数症状逐渐消失,但疲乏、口干、食欲下降依然存在并影响其生活质量.护理工作者应关注患者在院期间及出院后的症状发生情况,提供针对性的干预措施,提高其生活质量.

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