| Objective:This study is aimed, using scales to evaluate the frequency and severity of the symptoms and life quality related conditions of the patients with gynecological malignant tumors during their chemotherapy, and, by analysis of symptom clusters and factors associated with life quality, to provide basis for planning reasonable and effective interventions.Methods:This study belongs to cross-sectional study.122 patients with gynecological malignant tumors hospitalized in a third-class one-grade hospital of Jinan from 2015 June to 2016 January were included in our questionnaire survey. The following scales were used:Functional Assessment of Cancer Therapy-General(FACT-G), M. D. Anderson Symptom Inventory, Karnofsky Performance Score(KPS) and Hospital Anxiety and Depression Scale(HADS). The general characters of symptoms, life quality, the score of anxiety and depression and all of their dimensions and symptoms were described by means and standard deviations. Factor analysis was performed to determine the categories of symptom clusters based on the data from M. D. Anderson Symptom Inventory. One way ANOVA were conducted to access the influences of various demographic and clinical factors for the life quality of patients. For continuous variables, Spearman correlation coefficients were used to estimate the association. The influence of life quality was demonstrated by a model of MLR (Multiple Linear Regression).Results:1. The most common symptom is fatigue and poor appetite, accounted for 95.9%, followed by disturbed sleep, nausea, vomiting, lethargy and sadness. The highest score from poor appetite was 5.49±2.47, followed by disturbed vomiting and sadness, sleep, nausea and upset.2.Three symptom clusters obtained from factor analysis. The first cluster, which named digestive tract-sleep disorder cluster, includes nausea, disturbed sleep, distress, shortness of breath, poor appetite, sleep, sadness and vomiting. The second cluster, which named neuro-xerostomia cluster, includes numbness, amnesia, xerostomia. The third cluster, which named pain-fatigue cluster, includes pain and fatigue.3. The one way ANOVA showed that the life quality is significantly associated with the variables of occupation, type of disease, anxiety and depression (p< 0.05);KPS score, the degree of symptoms, degree of symptom disturbance, digestive tract-sleep disorder cluster, neuro-xerostomia cluster are pain-fatigue cluster are negatively correlated with the quality of life (p< 0.05).4. The MLR showed that, among above significant variables, depression, anxiety, digestive tract-sleep disorder cluster and pain- fatigue cluster are influencing factors for life quality,which interpreted 69.2% variance.Conclusion:1. The most common and severe symptom is poor appetite, which prompts medical workers to be clear with the patient’s symptoms and take interventions to minimize patient symptoms.2. The highest score of digestive tract-sleep disorder cluster indicates a need for nursing personnel to strengthen the management of symptoms, to alleviate digestive tract reactions and to improve the quality of sleep.3. The influence factors of gynecological malignant tumor patients’quality of life, including the digestive tract-sleep disorder cluster, neuro-xerostomia cluster, anxiety and depression, among which anxiety and depression are the most important influence factors. Consequently, we should actively take effective intervention measures to do pain assessment, to strengthen propaganda and education and to provide support treatment. |
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