Lung Cancer Patients' Perioperative Symptom Clusters Of Longitudinal Study

BackgroundLung cancer has become one of the most common malignancies over the years,with the development of lung cancer,series of symptoms associated with the disease or treatment,these symptoms seriously affect the quality of life of patients.Surgery is now the predominant active treatment for lung cancer clinically.Compared to the single symptom,symptom cluster can better improve the efficiency of symptom management.To strengthen symptoms management may effectively help to accomplish the operation,promote postoperative recovery and prevent some complications.However,there are few reports of lung cancer patients in the perioperative period of symptom clusters.The study of perioperative symptoms is profitable to enhance the therapeutic effect,relieve symptoms and improve patients' life quality.ObjectiveTo investigate the severity of symptoms of lung cancer patients during periopera tive period,explore the composition of symptom clusters at different time points of the perioperative period and study the dynamic variation rule.The aim of this study was to provide a theoretical basis for proposing proper symptom management strategies,and help lung cancer patients to fulfill the goal minimizing the symptom distress and optimizing the life quality.MethodsIn this study,a prospective study was conducted on 120 lung cancer patients 1-3 days before the surgery(T1),1-3 days after surgery(T2)and 1-3 days before discharge(T3).Survey general information,using the Chinese version of the M.D.And erson symptom inventory(MDASI)and the specific lung cancer module of MDASI as an assessment tool.Using SPSS16.0 software to analyze the data.Using exploratory factor analysis to analyze the composition of the three time points in the peri operative period of lung cancer.Results1.The severity of the symptoms of lung cancer patients during perioperative period:The scores of the symptoms of lung cancer patients before the surgery: sad(5.51±1.52),distress(3.43±1.06),restless(2.82±0.91),cough(2.63±1.08),tired(2.55±0.46),dyspnea(2.13±0.91),badappetite(2.03±1.01),loseweight(2.02±0.53),pain(1.92±0.63),shortbreath(1.66±1.28),cough(1.46±0.89),lethargy(1.08±0.41).The severity of the symptoms of lung cancer patients after the surgery: pain(5.82±1.39),tired(5.31±1.57),cough(4.54±1.06),badappetite(4.05±1.32),restless(4.19±1.55),distress(3.81±1.68),dyspnea(3.39±1.40),expectoration(3.29±1.41),sad(3.14±1.77),shortbreath(3.10±1.08),constipation(2.81±0.59),dry mouth(2.70±0.73),loseweight(2.46±1.07),nausea(2.35±0.86),vomit(2.03±0.61),lethargy(1.78±0.41),hemoptysis(1.52±0.49),forgetful(0.84±0.32),numbness(0.88±0.37).The severity of the symptoms of lung cancer patients before discharge: tired(3.52±2.13),sad(3.49±1.12),distress(3.43±1.06),restless(2.82±1.69),cough(2.73±0.83),dyspnea(2.21±0.72),badappetite(2.14±0.74),loseweight(2.11±0.67),pain(1.94±0.59),shortbreath(1.71±0.31),expectoration(1.53±0.51),constipation(1.01±0.32),dry mouth(1.01±0.47).2.The constructions of the symptom clusters during the perioperative period.Symptom clusters before the surgery included fatigue symptom clusters,emotional symptom clusters and respiratory symptom clusters.Symptom clusters after the surgery included fatigue symptom clusters,respiratory symptom clusters,emotional symptom clusters,digestive symptom clusters,dry symptom clusters,nervous symptom clusters,hypoxia symptom clusters.Symptom clusters before discharge included fatigue symptom clusters,respiratory symptom clusters,emotional symptom clusters,hypoxia symptom clusters and dry symptom clusters.Conclusion1.The intensity of the symptoms of lung cancer during perioperative period: The first three symptoms were sadness,distress and fatigue before the surgery;pain,fatigue and cough after the surgery;fatigue,sadness and distress before discharge.2.Lung cancer in perioperative patients with symptoms of different points in time can gather in groups.The symptom clusters has certain stability and dynamics.group Emotional?fatigue symptoms and respiratory tract symptom clusters were found in three time periods,and the digestive tract symptoms and neurological symptoms appeared only after surgery.