Study On The Construction Of Distress Management Platform For Lung Cancer Patients With Chemotherapy

ObjectiveTo investigate the degree of distress,anxiety and depression in lung cancer patients with chemotherapy,to explore factors associated with distress,to explore the relationship between distress,anxiety and depression.To construct the distress management platform for lung cancer patients with chemotherapy,so as to provide guidance for web-based distress management among cancer patients in the future.Methods1.A random sample of 438 lung cancer patients with chemotherapy were investigated by using the demographic questionnaire,Distress Management Screening Measure,Generalized Anxiety Disorder 7-Item Scale and Patient Health Questionnaire Depression 2-Item Scale,to explore the degree and influencing factors of distress in lung cancer patients with chemotherapy.2.On the basis of cross-sectional survey,literature and guideline review and group discussion,the module contents of distress management platform for lung cancer patients with chemotherapy was preliminarily constructed.Two rounds of questionnaires were sent to 19 experts in related fields through the Delphi method,and the experts scored the importance and feasibility of each module and item.According to the results of expert consultation,a group discussion was conducted to delete,add and modify the modules and items,and finally to determine the module contents of this platform.The data were analyzed by SPSS18.0,measurement data were described by mean and standard deviation,count material were described by frequency and composition ratio;Correlation analysis used Spearman rank correlation analysis;Chi-square test or Fisher’ s exact test was used for univariate analysis;Logistic regression analysis was used for multivariate analysis.The reliability of consultants was described by experts’ positive coefficient,authority coefficient and Kendall’ s W;The importance and feasibility of each module and item were described by means,standard deviation and variation coefficient.Results1.162(38.57%)of 420 lung cancer patients with chemotherapy had a significant distress,with an average score of 3.20±2.11.The top 10 problems with the highest frequency in the list of distress related problems were: financial,worry,fatigue,eating,pain,breathing,nausea,sleep,constipation and nervous.2.There were significant differences in the positive rate of distress among lung cancer patients with chemotherapy in different working conditions,types of medical insurance and clinicopathological staging(P < 0.05).3.The average score of anxiety and depression in 420 patients were 3.05±3.15 and 0.48±0.86 respectively.Spearman correlation analysis showed that there was a positive correlation between distress scores and anxiety and depression scores in lung cancer patients with chemotherapy(correlation coefficient r was 0.57,0.52,P < 0.001).4.The enthusiasm of experts in the two rounds were 89.47% and 100% respectively,and the experts who made comments accounted for 76.47% and 35.29% respectively;Experts’ authority coefficient was 0.924;Kendall’ s W was 0.336 and 0.367 in the first round and 0.353 and 0.370 in the second round,respectively,with statistical significance(P < 0.05).5.According to the results of two rounds of expert consultation,a group discussion was conducted to delete the module or item with the average score of importance or feasibility < 3.5 and variation coefficient > 0.25,and to add and modify the module or item with higher concentration of expert opinions.The final module of the distress management platform consists of 3 ports,16 modules and 52 Specific items.Conclusions1.The distress of lung cancer patients with chemotherapy was at a high level,the dimensions with high frequency of problems list were practical problems,physical problems and emotional problems,so it is necessary to strengthen the management of distress among lung cancer patients with chemotherapy.The main influencing factors of the positive rate of distress were the working conditions,types of medical insurance and clinicopathological staging.2.The module contents of distress management platform for lung cancer patients with chemotherapy based on Delphi method was scientific and reliable,which can provide guidance for web-based distress management among cancer patients in the future.