国际肿瘤学杂志

国际肿瘤学杂志 ›› 2020, Vol. 47 ›› Issue (1): 18-23.doi: 10.3760/cma.j.issn.1673-422X.2020.01.003

• 论著 • 上一篇    下一篇

感知控制、自我管理对乳腺癌化疗患者癌因性疲乏的影响

李冉冉1,2, 杨富国1(), 范敏2, 黄伟2, 袁芳2   

  1. 1 青岛大学护理学院 266021
    2 山东省肿瘤防治研究院(山东省肿瘤医院)放疗科 山东第一医科大学(山东省医学科学院),济南 250117;
  • 收稿日期:2019-11-18 修回日期:2019-12-13 出版日期:2020-01-08 发布日期:2020-03-22
  • 通讯作者: 杨富国 E-mail:yfuguo@126.com
  • 基金资助:
    国家自然科学基金(81773232)

Effect of perception control and self-management on cancer-related fatigue in breast cancer patients with chemotherapy

Li Ranran1,2, Yang Fuguo1(), Fan Min2, Huang Wei2, Yuan Fang2   

  1. 1 School of Nursing, Qingdao University, Qingdao 266021, China
    2 Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy Medical Sciences, Jinan 250117, China
  • Received:2019-11-18 Revised:2019-12-13 Online:2020-01-08 Published:2020-03-22
  • Contact: Yang Fuguo E-mail:yfuguo@126.com
  • Supported by:
    National Natural Science Foundation of China(81773232)

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摘要：

目的 了解乳腺癌化疗患者感知控制、自我管理与癌因性疲乏(CRF)的现状,探讨感知控制、自我管理对CRF的影响。方法 采用横断面调查法抽取山东省肿瘤防治研究院246例乳腺癌化疗患者进行问卷调查。采用癌症经验与效能量表评估患者的感知控制水平,癌症患者自我管理测评量表评估患者的自我管理水平,Piper疲乏量表评估患者的CRF情况。比较不同人口学资料患者的CRF评分情况,分析感知控制、自我管理行为对患者CRF的影响。结果 不同文化程度(F=3.392,P=0.019)、医疗费用来源(F=4.368,P=0.005)、疾病分期(F=4.376,P=0.005)、化疗周期(F=3.865,P=0.010)、病程(F=3.094,P=0.028)的患者CRF评分差异均具有统计学意义。乳腺癌化疗患者感知控制的癌症经验(F=7.248,P=0.001)、控制效能(F=96.595,P<0.001)、癌症患者自我管理(F=65.009,P<0.001)、CRF(F=130.973,P<0.001)各维度差异均具有统计学意义。感知控制中的癌症经验与CRF呈正相关(r=0.467;P<0.001);控制效能、癌症患者的自我管理与CRF呈负相关(r=-0.505,P<0.001;r=-0.564,P<0.001)。多元线性回归显示,医疗费用来源(以商业保险为参照组)、化疗周期(化疗周期≥6周期为参照组)、癌症经验、控制效能与自我管理进入回归模型,对CRF解释率为55.5%,且存在显著的线性关系(F=17.100,P<0.001)。结论 医护人员应重点关注自费及处于2~5化疗周期患者的CRF;癌症经验与CRF呈正相关,控制效能、自我管理行为与CRF呈负相关。

关键词: 乳腺肿瘤, 疲劳, 影响因素分析, 感知控制

Abstract:

Objective To understand the status quo of perception control, self-management and cancer-related fatigue (CRF) in breast cancer patients receiving chemotherapy, and to investigate the impacts of perception control and self-management on CRF. Methods In this study, 246 breast cancer patients undergoing chemotherapy from Shandong Cancer Hospital and Institute were investigated by means of cross-sectional survey. Cancer experience and efficiency scale was used to evaluate the patients' perception control; cancer patients' self-management scale was used to assess their self-management; and Piper Fatigue Scale was used to evaluate their CRF. Finally, the scores of CRF among the patients with different demographic data were compared, and the effects of perception control and self-management behavior on CRF were analyzed. Results In univariate analysis, there were statistically significant differences of CRF scores resulting from different educational backgrounds (F=3.392, P=0.019), sources of medical cost (F=4.368, P=0.005), disease stages (F=4.376, P=0.005), chemotherapy periods (F=3.865, P=0.010) and courses of disease (F=3.094, P=0.028). The differences in each dimension of perceived control cancer experience (F=7.248, P=0.001), control efficacy (F=96.595, P<0.001), self-management level of cancer patients (F=65.009, P<0.001) and CRF (F=130.973, P<0.001) were statistically significant. Cancer experience in perception control was positively correlated with CRF (r=0.467, P<0.001); control effectiveness and self-management of cancer patients were negatively correlated with CRF (r=-0.505, P<0.001; r=-0.564, P<0.001). Multiple linear regression showed that source of medical expenses (setting commercial insurance as the reference group), chemotherapy cycle (setting chemotherapy cycle ≥ 6 cycles as the reference group), cancer experience, control effectiveness, and self-management were entered in regression models, which could explain 55.5% of the total variation in CRF scores, and there was a significant linear relationship (F=17.100, P<0.001). Conclusion Medical staff should focus on CRF in patients at their own expense and in the 2-5 chemotherapy cycles. Cancer experience is positively correlated with CRF. Control effectiveness and self-management behavior are negatively correlated with CRF.

Key words: Breast neoplasms, Fatigue, Analysis of influence factor, Perception control