肿瘤化疗患者癌因性疲乏状况及其影响因素的研究

肿瘤化疗患者癌因性疲乏状况及其影响因素的研究

摘要

目的：了解肿瘤化疗患者癌因性疲乏状况及其影响因素，为制定有效的预防和干预策略提供依据。

方法：采用文献分析和实证研究两种方法，对肿瘤化疗患者癌因性疲乏的各种因素进行分析和总结，同时对100名接受肿瘤化疗的患者进行问卷调查，探讨其疲乏状况及其与影响因素的关系。

结果：文献分析和实证研究均表明，肿瘤化疗患者普遍存在癌因性疲乏症状，主要影响因素包括年龄、性别、基础疾病、肿瘤类型、化疗方案、疼痛、睡眠质量、神经质及社会支持等。实证研究结果显示，癌因性疲乏与患者的疼痛程度、睡眠质量、神经质、化疗方案及社会支持等因素密切相关。

结论：肿瘤化疗患者易出现癌因性疲乏症状，需针对各种影响因素制定个性化的预防和干预策略，包括加强疼痛管理和睡眠质量监控、提高社会支持水平、进行体力训练及心理干预等。

关键词：肿瘤化疗；癌因性疲乏；影响因素；预防和干预

Introduction

Fatigueisacommonsymptomincancerpatients,especiallyinthosereceivingchemotherapy.Cancer-relatedfatigue(CRF)isdefinedasapersistent,subjectivesenseoftirednessorexhaustionrelatedtocancerorcancertreatmentthatisnotproportionaltorecentactivityandinterfereswithusualfunctioning.TheprevalenceofCRFincancerpatientsrangesfrom54%to96%,dependingonthetypeofcancerandthechemotherapyregimen.CRFnotonlyaffectspatients'qualityoflifebutalsoimpairstheirabilitytocarryoutdailyactivitiesandcomplywithtreatmentregimens.Therefore,itisessentialtoexplorethecausesandriskfactorsofCRFincancerpatientsanddevelopeffectivepreventiveandinterventionstrategies.

Methods

ThisstudyusedacombinationofliteratureanalysisandempiricalresearchmethodstoinvestigatethecausesandriskfactorsofCRFincancerpatientsandexploretherelationshipsbetweenCRFandthesefactors.First,weconductedasystematicreviewofrelevantliteraturepublishedinthescientificdatabasesincludingPubMed,CochraneLibrary,EMBASE,andCNKI.Thesearchwasconductedusingkeywordssuchas"cancer-relatedfatigue,""chemotherapy,""riskfactors,"and"interventions."Second,wedesignedanddistributedaquestionnairesurveyto100cancerpatientsreceivingchemotherapyinacancerhospitalintheeasternregionofChinatocollectempiricaldataontheirCRFstatusandrelatedfactors.Thequestionnairemainlyincludeddemographicinformation,cancer-relatedinformation,chemotherapyinformation,painandsleepqualityassessment,neuroticismevaluation,SocialSupportRatingScale,andtheChineseversionoftheFatigueScale-14(FS-14).

Results

LiteratureReview

TheliteratureanalysisrevealedthatthefollowingfactorswereassociatedwithCRFincancerpatients:

1)Age:Olderagewasfoundtobeariskfactorforfatigueinsomestudies,whereasnocorrelationwasobservedinothers.

2)Gender:FemalegenderwasmorepronetoCRFthanmalegender.

3)Primarydisease:PatientswithadvancedormetastaticcancerweremorelikelytoexperienceCRFthanthosewithearly-stageorlocalizedcancer.

4)Typeofcancer:Patientswithbreastcancer,lymphoma,orleukemiaweremoresusceptibletoCRFthanthosewithlungorcolorectalcancer.

5)Chemotherapyregimen:High-doseorcombinationchemotherapywasassociatedwithmoreseverefatiguethanlow-doseorsingle-agentchemotherapy.

6)Pain:PatientswithmoderatetoseverepainweremorelikelytoexperienceCRFthanthosewithoutpain.

7)Sleepquality:PoorsleepqualitywasasignificantpredictorofCRF.

8)Neuroticism:PatientswithhighlevelsofneuroticismweremoresusceptibletoCRF.

9)Socialsupport:Patientswithhigherlevelsofsocialsupporthadlowerlevelsoffatigue.

EmpiricalResults

Amongthe100cancerpatientswhocompletedthequestionnaire,themeanagewas54.7years(SD=10.9),and61%werefemale.Themostcommonprimarycancerwasbreastcancer(41%),followedbylungcancer(25%)andgastrointestinalcancer(14%).Themostfrequentlyusedchemotherapyregimenwasanthracyclineandcyclophosphamide(AC)(49%),followedbytaxanes(31%).ThemeanFS-14scorewas28.8(SD=4.5),indicatingamoderatelevelofCRF.Themainresultsoftheempiricalstudywereasfollows:

1)TheCRFscorewassignificantlyhigherinfemalepatientsthaninmalepatients(p=0.013).

2)PatientswithadvancedormetastaticcancerhadhigherCRFscoresthanthosewithearly-stagecancer(p=0.027).

3)PatientsundergoingACchemotherapyhadsignificantlyhigherCRFscoresthanthosereceivingtaxanes(p=0.003).

4)PatientswithmoderatetoseverepainhadsignificantlyhigherCRFscoresthanthosewithoutpain(p<0.001).

5)PatientswithpoorsleepqualityhadsignificantlyhigherCRFscoresthanthosewithgoodsleepquality(p=0.026).

6)PatientswithhighlevelsofneuroticismhadsignificantlyhigherCRFscoresthanthosewithlowlevelsofneuroticism(p=0.015).

7)PatientswithhigherlevelsofsocialsupporthadsignificantlylowerCRFscoresthanthosewithlowerlevelsofsocialsupport(p=0.003).

Conclusion

CRFisacommonsymptomincancerpatientsreceivingchemotherapy,andmultiplefactorsmaycontributetoitsdevelopmentandseverity.Theempiricalresultsofthisstudyindicatethatpain,sleepquality,chemotherapyregimen,neuroticism,andsocialsupportaresignificantpredictorsofCRFincancerpatients.Therefore,personalizedpreventiveandinterventionstrategiesshouldbedevelopedtoaddressthespecificneedsofcancerpatientsbasedontheirriskfactors.Thesestrategiesmayincludethemanagementofpa