| Objective:To understand the symptom characteristics and TCM constitution distribution characteristics of cervical cancer patients with concurrent radiotherapy and chemotherapy,to determine the symptom clusters and the influencing factors of different symptom clusters in patients with cervical cancer concurrent radiotherapy and chemotherapy,and to explore the relationship between symptom clusters and TCM constitution in patients with cervical cancer concurrent radiotherapy and chemotherapy.Methods:From December 2021 to November 2022,inpatients who were diagnosed with cervical cancer and underwent concurrent chemoradiotherapy in the departments of gynecology,oncology and radiotherapy of three tertiary hospitals in Nanning were selected,and a self-made general situation questionnaire was used,Anderson Symptom Assessment Scale,Traditional Chinese Medicine Constitution Classification and Judgment Form to conduct a questionnaire survey on patients.SPSS26.0 software was used to conduct descriptive analysis,principal component analysis,single factor analysis,multivariate analysis and correlation analysis of the data.Results:(1)The incidence of 13 symptoms in 284 cervical cancer patients with concurrent radiotherapy and chemotherapy ranged from 64.1%to 93.0%,and the highest incidence was fatigue(93.0%),followed by nausea(90.1%)and loss of appetite(88.7%),Sadness(88.7%).The incidence rate of symptom distress ranged from 68.3%to 90.8%,among which the highest incidence rate was 90.8%for work(including housework).(2)A total of 9 TCM constitutions appeared in patients with cervical cancer concurrent radiotherapy and chemotherapy,among which Qi deficiency constitution(37.3%)appeared most,followed by Yang deficiency constitution(20.8%),Qi stagnation constitution(15.8%),peaceful constitution(3.2%),phlegm-dampness(3.5%),dampness-heat(1.1%),and idiosyncratic(1.4%)appeared less frequently.(3)Four symptom clusters of cervical cancer patients with concurrent radiotherapy and chemotherapy were extracted through principal component analysis.Gastrointestinal symptom cluster included vomiting,nausea,loss of appetite,and dry mouth;physical symptom cluster included fatigue,pain,restless sleep,and emotional symptom cluster Including sadness,distress,side effect symptom cluster including forgetfulness,shortness of breath,drowsiness,numbness,explained 68.367%of the total variation of observed variables.(4)The results of univariate analysis showed that age,education level,chemotherapy regimen,chemotherapy cycle,number of radiotherapy,and whether combined with chronic diseases had statistically significant differences in gastrointestinal symptom cluster scores(P<0.05);age,marriage,education level,disease stage,chemotherapy cycle,and radiotherapy times had statistically significant differences in physical symptom cluster scores(P<0.05);age,education level,per capita disposable monthly income,and chemotherapy program had statistically significant differences in emotional symptom cluster scores(P<0.05);the difference in age,disease stage,chemotherapy regimen,chemotherapy cycle,and whether combined with chronic diseases was statistically significant in side effect symptom cluster scores(P<0.05).(5)The results of multiple linear regression showed that the influencing factors of the gastrointestinal symptom cluster included chemotherapy regimen,chemotherapy cycle,radiotherapy times,and whether there was a chronic disease,which explained 57.3%of the variation of the gastrointestinal symptom cluster(adjusted R~2=0.573);the influencing factors of the physical symptom cluster included age,disease Stage,chemotherapy cycle,and radiotherapy times explained 42.7%of the variation in the physical symptom cluster(adjusted R~2=0.427);the influencing factors of the emotional symptom cluster included age,per capita disposable monthly income,and chemotherapy regimens,which explained 45.2%of the variation in the emotional symptom cluster(adjusted R~2=0.452);Influencing factors included disease stage,chemotherapy regimen,and chronic disease,which explained37.3%of the variation in side effect symptom cluster(adjusted R~2=0.373).(6)The results of Spearman correlation analysis showed that there was a positive correlation between the gastrointestinal symptom cluster and yang deficiency constitution(r_s=0.533)and qi stagnation constitution(r_s=0.136)in patients with cervical cancer concurrent radiotherapy and chemotherapy(P<0.05);The physical symptom cluster was positively correlated with the quality of qi deficiency(r_s=0.531),yin deficiency(r_s=0.236),phlegm dampness(r_s=0.138)and blood stasis(r_s=0.322,P<0.05);There is a positive correlation between emotional symptom cluster and qi deficiency(r_s=0.257)and qi stagnation constitution(r_s=0.448,P<0.05);side effect symptom cluster was associated with qi deficiency constitution(r_s=0.264),yang deficiency constitution(r_s=0.304),blood stasis constitution(r_s=0.252).There is a positive correlation(P<0.05).Conclusions:(1)The influencing factors of different symptom clusters in cervical cancer patients with concurrent radiotherapy and chemotherapy are different,and the same influencing factor may also affect different symptom clusters,suggesting that medical workers can formulate personalized nursing measures according to the influencing factors of different symptom clusters,and at the same time by identifying specific and common influencing factors,in order to optimize the clinical intervention plan.(2)There is a correlation between the symptom clusters and TCM constitution in patients with cervical cancer concurrent radiotherapy and chemotherapy.Therefore,clinical work should be based on the idea of"holistic view of traditional Chinese medicine"and"discrimination and nursing",combine symptom clusters with traditional Chinese medicine constitution,provide personalized integrated traditional Chinese and western medicine intervention for patients with different constitutions,and improve the effectiveness of intervention.Effectiveness in reducing symptom burden in cancer patients. |
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