The Symptom Clusters Of Patients With Tracheostomy Cannula After Head And Neck Cancer Surgery And The Relationship With Stigma And Psychological Resilience

Objective To investigate the symptom features of patients with tracheostomy cannula after head and neck cancer surgery and to extract symptom clusters.To analyze the influence of stigma and psychological resilience on symptom clusters,which would provide new ideas for the management and intervention of symptom clusters.Method A convenient sampling method was used to select 203 patients with tracheostomy cannula after head and neck cancer surgery.The survey tools included General Condition Questionnaires,MDASI-H&N,Schizophrenia Scale,and CD-RISC10.SPSS22.0 software was used for data entry,collation and analysis.The main statistical methods included exploratory factor analysis,independent sample t-test,single factor variance analysed,pearson correlation analysis and hierarchical regression analysis.Results1.Socio-demographic and clinical data of the study population:Two hundred and three patients with tracheostomy cannula after head and neck cancer surgery,age ranged 41-84 years,with an average score of(61.66±8.53)years;male-dominated,accounting for 90.6%;55.2%of patients had the junior high school and the following level,The main diagnosis was laryngeal cancer(46.8%)and hypopharyngeal cancer(44.3%);The stage ? period of the disease was 34.5%,22.7%in stage ?,27.1%in stage ?,and 15.8%in stage ?.65.5%of patients had undergone surgery and radiation therapy at the same time.The time of catheters was 24.1%in 1 month,32.5%in 1?3 months,and 43.3%in 3 months.2.Analysis of the symptom incidence,severity and daily life disturbance of the studies:The incidence of symptoms in patients with tracheostomy cannula after head and neck cancer surgery was between 17.2%and 99.5%,and the incidence of interference with daily life of patients was between 15.3%and 99.5%.Trouble(distress)was the highest symptom incidence(99.5%)and severity(4.94±1.80),and the highest symptom incidence of interference(99.5%)occurred at work.3.Extraction of symptom clusters from the study subjects:Four symptom clusters were extracted using exploratory factor analysis.The neck cancer-specific symptoms include pain,distress(trouble),shortness of breath,sadness,swallowing,and coughing(female congestion),vocalization(difficulty speaking),abnormal taste;2 sleep disorders include fatigue(fatigue),disturbed sleep,sleepiness;3 gastrointestinal symptoms cluster includes nausea,poor appetite,constipation;4 head cancer group of radiotherapy symptoms include mouth Dry,throat mucus problems,pruritus,oral soreness.4.Independent sample t-test and single factor variance analysis showed that:Head and neck cancer specific symptom clusters,radiotherapy symptom clusters and sleep disturbance in the general population(age,gender,origin,cultural degree,economic conditions)and disease information(history,disease stage,clinical stage,treatment)differ(P<0.05);Pearson correlation analysis showed that,except for gastrointestinal symptoms,other symptom clusterss were positively correlated with stigma(r== 0.552?0.751,P<0.01),which was negatively correlated with mental resilience(r=-0.564?0.805,P<0.01).The patients with head and neck cancer specific symptom clusters,radiotherapy symptom clusters and sleep symptom clusters were the dependent variables respectively,the demographic sociology and clinical information with statistical significance in single factor analysis were included as the control variables in the first layer,stigma variables were included in the second layer,and psychological resilience variables were included in the third layer for hierarchical regression analysis,the results show that,Explanation of the stigma and psychological resilience to the specific symptom clusters of head and neck cancer were 13.4%and 7.3%respectively;Explanation of the stigma and psychological resilience to the radiotherapy symptom clusters of head and neck cancer were 7.7%and 5.4%respectively;Explanation of the stigma and psychological resilience to the symptom clusters of sleep disorders were 9.9%and 2.1%,respectively.Conclusion1.The incidence and seriousness of distress(disturbance)in the patients with tracheostomy cannula for head and neck cancer were the highest,and the incidence of interference with work was the highest.2.Patients with tracheostomy cannula after head and neck cancer surgery showed four symptom clusters:head and neck cancer specific symptoms cluster,sleep disorder cluster,gastrointestinal symptom cluster,head and neck cancer radiotherapy symptom cluster.3.Apart from the influence of the general population sociological information and clinic information,the symptomatic clusters of tracheostomy cannula for head and neck cancer surgery are also significantly positively correlated with stigma and negatively correlated with psychological elasticity.These provide a new basis for the symptom clusters that can effectively interfere with patients.