Correlation Study On Symptom Cluster And Fear Of Disease Progression In Patients After Oesophagectomy

Objective:To investigate the fear of disease progression and symptom cluster in patients after oesophagectomy in Jiangxi Province.To analyze the influencing factors of the fear disease progression in patients after oesophagectomy.To explore the correlation between the fear disease progression and the severity of symptom clusters in patients after oesophagectomy.The purpose of this study was to focus on the effect of the severity of symptom clusters on the fear of disease progression in patients after oesophagectomy,and to provide a clear direction for the care of fear disease progression in patients after oesophagectomy in the future.Methods:Convenience sampling method was adopted to select 158 cases of patients after oesophage-ctomy in 4 tertiary hospitals in Jiangxi Province.Chinese version of the fear of disease progression,Chinese version of the Memory Assessment Scale(MSAS-Ch)and general situation questionnaire were used to conduct a one-to-one questionnaire survey.The demographic sociology features and disease-related characteristics of patients,the incidence of symptoms,the degree of frequency,severity,distress of symptoms,the fear of disease progression and its various dimensions scored using a general descriptive analysis.Exploratory factor analysis was used to extract the symptom cluster present in symptoms with an incidence of ?20%.The internal consistency of symptom cluster was evaluated by Cronbach's coefficients.Spearman correlation was used to analyze the relationship between the fear of disease progression and the severity of symptom clusters.Results:1.The total fear of disease progression score for patients after oesophagectomy was(27.93±5.78)points.The score of the score of social and family was(12.62±3.08)points and physical health dimension was(15.31±3.43)points.The pepercentage of patients after oesophagectomy who exceeded the normal level was about 18.35 percent.2.Within thirty symptoms has founded in patients after oesophagectomy,there were twenty-one,s incidence exceeded twenty percent.The incidence top five symptoms were pain,dry month,cough,lack of energy,shortness of breath;the degree of frequency top five symptoms were dry month,pain,feeling sad,feeling bloated,difficulty swallowing;the degree of severity top five symptoms were pain,numbness/tingling in hands/feet,“I don,t like myself”,dry month,difficulty swallowing;the degree of distress top five symptoms were pain,dry month,numb-ness/tingling in hands/feet,constipation,lack of appetite.3.There were 6 symptom clusters in patients after oesophagectomy.In order of relative severity,they are breathing-related symptom cluster(cough,pain,shortness of breath),eating-related symptom cluster(weight loss,difficulty swallowing,change in the way food taste,dry month,constipation),sickness feelings symptom cluster(lack of energy,numbness/tingling in hands/feet,dirriness),psychologic symptom cluster(difficulty concentrating,feeling sad,feeling nervous,“I don,t like myself”,worring),sleeping-related symptom cluster(difficulty sleeping,feeling drowsy),autonomic disorder symptom cluster(diarrhea,itching,sweats).4.It's statistic significant of differences in fear of disease progression score for patients after oesophagectomy with different gender,age,tumor stage(P<0.05).5.The severity of breathing-related symptom cluster,eating-related symptom cluster,sickness feelings symptom cluster,psychologic symptom cluster,autonomic disorder symptom cluster were positively correlated with the fear of disease progression in patients after oesophagectomy,correlation coefficient was 0.225-0.498(P<0.05).Conclusions:1.The fear of disease progression in patients after oesophagectomy at a moderate level,and the incidence of the mental dysfunction ones at a low level.2.There are multiple symptoms in patients after oesophagectomy.There are some difference in the incidence,the degree of frequency,severity,distress among different symptoms.3.There were six symptom clusters observed in patients after oesophagectomy.4.Age,tumor stage,gender,the severity of psychologic symptom cluster,eating-related symptom cluster,autonomic disorder symptom cluster,breathing-related symptom cluster,sickness feelings symptom cluster were the influencing factors of the fear of disease progression.