Investigation of symptom clusters and related interference on daily life of lung cancer patients undergoing concurrent chemoradiation therapy_West China Medical Journal

Authors：

LI Yimin , MENG Na ,  YU Chunhua

Department of Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YU Chunhua, Email: 724478785@qq.com

Keywords：

Lung cancer; Concurrent chemoradiation therapy; Symptom cluster

DOI：

10.7507/1002-0179.201706228

Video：

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Objective To explore the incidence and severity of symptoms of the lung cancer patients undergoing concurrent chemoradiation therapy, and reveal the influence of symptom clusters on the patients’ daily activities. Method From December 2016 to June 2017, a total of 150 patients with lung cancer who underwent concurrent chemoradiation therapy were investigated by using M. D. Anderson Symptom Inventory of Chinese Version and the revised lung cancer module. Results For the patients during the period of concurrent chemoradiation therapy, the symptoms with severity score >5 were fatigue, nausea, poor appetite, cough, distress, disturbed sleep, vomiting, expectoration, and grief; the symptoms with incidence >80% were fatigue, nausea, disturbed sleep, poor appetite, grief, and cough. Joy of life (87.33%), emotion (74.38%), and work (72.67%) were the top three in terms of high incidence of symptom distress. Exploratry factor analysis revealed 4 major symptom clusters, which were fatigue-related symptom cluster, gastrointestinal symptom cluster, emotion symptom cluster, and respiratory symptom cluster. Conclusions During the period of concurrent chemoradiation therapy, lung cancer patients suffer from multiple symptom clusters. Medical staff should assess symptoms timely, and provide effective interventions, to improve the patients’ quality of life.

Citation： LI Yimin, MENG Na, YU Chunhua. Investigation of symptom clusters and related interference on daily life of lung cancer patients undergoing concurrent chemoradiation therapy. West China Medical Journal, 2017, 32(10): 1567-1571. doi: 10.7507/1002-0179.201706228 Copy

1.	喻微, 葉波, 續力云, 等. 實性孤立性肺結節診斷模型的建立. 中國肺癌雜志, 2016, 19(10): 705-710.
2.	姜男, 陳小岑, 趙岳. 肺癌患者同步放化療期間癥狀群的調查研究. 中國全科醫學, 2012, 15(33): 3866-3869.
3.	李焱, 楊敬敬. 沙利度胺與 NP 方案聯合治療晚期非小細胞肺癌的療效觀察. 疑難病雜志, 2011, 10(6): 435-437.
4.	仇蓉, 吳綺珣, 周娟, 等. 知信行模式干預對細胞因子誘導的殺傷細胞生物治療中晚期肺癌患者疼痛的影響. 護理管理雜志, 2015, 15(11): 805-807.
5.	宮偉利. 延續性自我管理對肺癌患者癌因性疲乏和生命質量的影響. 護理管理雜志, 2015, 15(10): 746-747.
6.	李玉, 李麗, 王國權, 等. 癌癥護理研究現狀及趨勢. 解放軍護理雜志, 2016, 33(4): 46-50.
7.	Dodd MJ, Miaskowski C, Paul SM. Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum, 2001, 28(3): 465-470.
8.	臧瑜, 于虹, 李妍, 等. 肺癌患者癥狀群的調查研究. 中華護理雜志, 2016, 51(3): 316-320.
9.	Wang XS, Wang Y, Guo H, et al. Chinese version of the M. D. Anderson Symptom Inventory: validation and application of symptom measurement in cancer patients. Cancer, 2004, 101(8): 1890-1901.
10.	Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist, 2011, 16(2): 217-227.
11.	張立力, 臧瑜. MD 安德森癥狀評估量表肺癌模塊的修訂和考評. 腫瘤, 2013, 33(5): 434-438.
12.	Maguire R, Stoddart K, Flowers P, et al. An interpretative phenomenological analysis of the lived experience of multiple concurrent symptoms in patients with lung cancer: a contribution to the study of symptom clusters. Eur J Oncol Nurs, 2014, 18(3): 310-315.
13.	Henoch I, L?vgren M. The influence of symptom clusters and the most distressing concerns regarding quality of life among patients with inoperable lung cancer. Eur J Oncol Nurs, 2014, 18(3): 236-241.
14.	Reyes-Gibby CC, Swartz MD, Yu X, et al. Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes. Support Care Cancer, 2013, 21(11): 3117-3125.
15.	Hsieh CC, Hsiao FH. The effects of supportive care interventions on depressive symptoms among patients with lung cancer: a meta analysis of randomized controlled studies. Palliat Support Care. (2017-05-14)[2017-06-01]. https://doi.org/10.1017/ S1478951517000335.
16.	Shen CH, Yang LY. The effects of acupressure on meridian energy as well as nausea and vomiting in lung cancer patients receiving chemotherapy. Biol Res Nurs, 2017, 19(2): 145-152.
17.	Hochberg U, Elgueta MF, Perez J. Interventional analgesic management of lung cancer pain. Front Oncol, 2017, 7: 17.
18.	Long NH, Thanasilp S, Thato R. A causal model for fatigue in lung cancer patients receiving chemotherapy. Eur J Oncol Nurs, 2016, 21(21): 242-247.
19.	Hung R, Krebs P, Coups EJ, et al. Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. J Pain Symptom Manage, 2011, 41(2): 426-435.
20.	Lou VW, Chen EJ, Jian H, et al. Respiratory symptoms, sleep, and quality of life in patients with advanced lung cancer. J Pain Symptom Manage, 2017, 53(2): 250-256.e1.
21.	Dong ST, Costa DS, Butow PN, et al. Symptom clusters in advanced cancer patients: an empirical comparison of statistical methods and the impact on quality of life. J Pain Symptom Manage, 2016, 51(1): 88-98.
22.	Trudel-Fitzgerald C, Savard J, Ivers H. Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Ann Behav Med, 2013, 45(3): 329-337.
23.	魏婷婷. 肺癌患者放療期間睡眠障礙與臨床因素及免疫學指標關系研究. 天津: 天津醫科大學, 2016.
24.	Chen E, Nguyen J, Cramarossa G, et al. Symptom clusters in patients with lung cancer: a literature review. Expert Rev Pharmacoecon Outcomes Res, 2011, 11(4): 433-439.
25.	Crawford JR, Smith G, Maylor EA, et al. The prospective and retrospective memory questionnaire (PRMQ): normative data and latent structure in a large non-clinical sample. Memory, 2003, 11(3): 261-275.
26.	Jiménez A, Madero R, Alonso A, et al. Symptom clusters in advanced cancer. J Pain Symptom Manage, 2010, 42(1): 24-31.
27.	周麗群, 凌云巧, 陳莉莉, 等. 辨證施護全程管理對肺癌患者干預研究. 遼寧中醫藥大學學報, 2017, 19(4): 197-199.
28.	王丹丹, 付菊芳, 房寧寧, 等. 肺癌患者的癥狀群及其與生活質量的相關性. 護理學雜志, 2012, 27(23): 5-8.

1. 喻微, 葉波, 續力云, 等. 實性孤立性肺結節診斷模型的建立. 中國肺癌雜志, 2016, 19(10): 705-710.
2. 姜男, 陳小岑, 趙岳. 肺癌患者同步放化療期間癥狀群的調查研究. 中國全科醫學, 2012, 15(33): 3866-3869.
3. 李焱, 楊敬敬. 沙利度胺與 NP 方案聯合治療晚期非小細胞肺癌的療效觀察. 疑難病雜志, 2011, 10(6): 435-437.
4. 仇蓉, 吳綺珣, 周娟, 等. 知信行模式干預對細胞因子誘導的殺傷細胞生物治療中晚期肺癌患者疼痛的影響. 護理管理雜志, 2015, 15(11): 805-807.
5. 宮偉利. 延續性自我管理對肺癌患者癌因性疲乏和生命質量的影響. 護理管理雜志, 2015, 15(10): 746-747.
6. 李玉, 李麗, 王國權, 等. 癌癥護理研究現狀及趨勢. 解放軍護理雜志, 2016, 33(4): 46-50.
7. Dodd MJ, Miaskowski C, Paul SM. Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum, 2001, 28(3): 465-470.
8. 臧瑜, 于虹, 李妍, 等. 肺癌患者癥狀群的調查研究. 中華護理雜志, 2016, 51(3): 316-320.
9. Wang XS, Wang Y, Guo H, et al. Chinese version of the M. D. Anderson Symptom Inventory: validation and application of symptom measurement in cancer patients. Cancer, 2004, 101(8): 1890-1901.
10. Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist, 2011, 16(2): 217-227.
11. 張立力, 臧瑜. MD 安德森癥狀評估量表肺癌模塊的修訂和考評. 腫瘤, 2013, 33(5): 434-438.
12. Maguire R, Stoddart K, Flowers P, et al. An interpretative phenomenological analysis of the lived experience of multiple concurrent symptoms in patients with lung cancer: a contribution to the study of symptom clusters. Eur J Oncol Nurs, 2014, 18(3): 310-315.
13. Henoch I, L?vgren M. The influence of symptom clusters and the most distressing concerns regarding quality of life among patients with inoperable lung cancer. Eur J Oncol Nurs, 2014, 18(3): 236-241.
14. Reyes-Gibby CC, Swartz MD, Yu X, et al. Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes. Support Care Cancer, 2013, 21(11): 3117-3125.
15. Hsieh CC, Hsiao FH. The effects of supportive care interventions on depressive symptoms among patients with lung cancer: a meta analysis of randomized controlled studies. Palliat Support Care. (2017-05-14)[2017-06-01]. https://doi.org/10.1017/ S1478951517000335.
16. Shen CH, Yang LY. The effects of acupressure on meridian energy as well as nausea and vomiting in lung cancer patients receiving chemotherapy. Biol Res Nurs, 2017, 19(2): 145-152.
17. Hochberg U, Elgueta MF, Perez J. Interventional analgesic management of lung cancer pain. Front Oncol, 2017, 7: 17.
18. Long NH, Thanasilp S, Thato R. A causal model for fatigue in lung cancer patients receiving chemotherapy. Eur J Oncol Nurs, 2016, 21(21): 242-247.
19. Hung R, Krebs P, Coups EJ, et al. Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. J Pain Symptom Manage, 2011, 41(2): 426-435.
20. Lou VW, Chen EJ, Jian H, et al. Respiratory symptoms, sleep, and quality of life in patients with advanced lung cancer. J Pain Symptom Manage, 2017, 53(2): 250-256.e1.
21. Dong ST, Costa DS, Butow PN, et al. Symptom clusters in advanced cancer patients: an empirical comparison of statistical methods and the impact on quality of life. J Pain Symptom Manage, 2016, 51(1): 88-98.
22. Trudel-Fitzgerald C, Savard J, Ivers H. Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Ann Behav Med, 2013, 45(3): 329-337.
23. 魏婷婷. 肺癌患者放療期間睡眠障礙與臨床因素及免疫學指標關系研究. 天津: 天津醫科大學, 2016.
24. Chen E, Nguyen J, Cramarossa G, et al. Symptom clusters in patients with lung cancer: a literature review. Expert Rev Pharmacoecon Outcomes Res, 2011, 11(4): 433-439.
25. Crawford JR, Smith G, Maylor EA, et al. The prospective and retrospective memory questionnaire (PRMQ): normative data and latent structure in a large non-clinical sample. Memory, 2003, 11(3): 261-275.
26. Jiménez A, Madero R, Alonso A, et al. Symptom clusters in advanced cancer. J Pain Symptom Manage, 2010, 42(1): 24-31.
27. 周麗群, 凌云巧, 陳莉莉, 等. 辨證施護全程管理對肺癌患者干預研究. 遼寧中醫藥大學學報, 2017, 19(4): 197-199.
28. 王丹丹, 付菊芳, 房寧寧, 等. 肺癌患者的癥狀群及其與生活質量的相關性. 護理學雜志, 2012, 27(23): 5-8.

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Investigation of symptom clusters and related interference on daily life of lung cancer patients undergoing concurrent chemoradiation therapy

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