| Objective:Lung cancer patients often have the toxic and side effects of chemotherapy in the form of cluster of symptoms during the intermittent period of chemotherapy.At this stage,patients often recuperate at home and lack of professional guidance from medical staff,which is not conducive to the remission and recovery of symptoms.This study will be through the investigation of patients with lung cancer chemotherapy intermission symptoms and to determine the levels of symptom group factor,to demand oriented and symptom management theory as the framework,build the lung cancer chemotherapy in patients with intermittent period symptom group management solutions,and explore its intermittent period of chemotherapy in patients with lung cancer group,the quality of life,and anxiety and depression symptoms.Methods:1.SurveyAnderson Symptom Assessment Scale was used to investigate the symptoms of lung cancer patients,to understand the incidence and severity of symptoms in patients with intermittent chemotherapy,and exploratory factor analysis was used to determine the number and composition of factors,providing more evidence and clues for the construction of symptom group management plan for lung cancer patients with intermittent chemotherapy.2.Scheme construction(1)Semi-structured interview: Through semi-structured interview of lung cancer chemotherapy patients,the dilemma and symptom management needs of lung cancer patients during the interval of chemotherapy were understood,so as to provide a basis for the construction of symptom group management plan.(2)Literature analysis: The first draft of symptom group management plan was formed after group discussion by searching common databases at home and abroad according to the search terms and searching relevant guidelines as supplements.(3)Expert meeting: Experts were invited to discuss the draft symptom cluster management plan according to the theme of the meeting to ensure the scientificity and effectiveness of the plan,and to revise and improve the draft symptom cluster management plan according to expert opinions and clinical practice.3.Empirical Research(1)Class I experimental study: From May to December 2021,90 patients with lung cancer who received initial chemotherapy in the oncology Department of a grade III Grade A hospital in Shanxi Province were selected as the research subjects.The patients were divided into groups according to the ward where they were admitted.The final patients involved in the study were 40 in the control group and 41 in the intervention group.The control group received routine telephone follow-up management during the interphase of chemotherapy,and the intervention group,on the basis of routine,increased symptom group management in the first three interphase of chemotherapy compared with the control group.Anderson Symptom Assessment Scale,Fact-L,Anxiety and depression Scale were used for evaluation before and after intervention.SPSS 25.0 software was used for data analysis,and P <0.05 was considered statistically significant.(2)Qualitative study: Objective sampling method was adopted to select 10 lung cancer patients and 11 primary caregivers who participated in the whole process of this study to conduct one-half structural interview.Colaizzi 7-step analysis method was adopted to comprehensively analyze all data and conduct theme extraction.Results:1.145 patients with lung cancer were investigated in this study,of which 137 were effective questionnaires with effective recovery of 94.50%.Exploratory factor analysis showed that the symptom group of lung cancer patients at home during the interval of chemotherapy could be divided into the following four categories: emotional,digestive tract,disease-related and perceptual symptom group,and the overall variance contribution rate was 67.99%.2.The draft symptom group management plan was formed by referring to the literature and analyzing and combining with the interview results.Finally,8 experts discussed the draft symptom group management plan of lung cancer patients during the intermittent chemotherapy according to the theme of the meeting through Tencent conference.After comprehensive consideration of experts’ opinions and combined with clinical practice,the project team modified and perfected the final version of intermittent chemotherapy symptom group management program for lung cancer patients.3.(1)Quantitative results:(1)Before intervention: general data,Anderson Symptom Assessment Scale,Fact-L,anxiety and depression of patients in the two groups were compared,and the results showed that there was no statistical difference(P>0.05).(2)After intervention: the quality of life,anxiety and depression scores of the two groups were statistically significant compared with the control group(P<0.05),and nursing satisfaction was also statistically different;There were statistically significant differences in mood and digestive tract symptom groups(P<0.05),while some symptoms in disease-related and chemotherapy-related symptom groups improved,but there was no statistical difference(P >0.05).(2)Qualitative results: Through sorting out and analyzing the interview data of 10 lung cancer patients and 11 primary caregivers,four major themes were analyzed: the impact on patients themselves,the impact on the primary caregivers,the impact on the family and the need for improvement.Conclusion:Symptom group management is a new type of nursing intervention,based on t he needs of patients,through the evaluation of symptoms,the implementation of sy mptom group management for lung cancer patients during the interval of chemother apy,can reduce part of the symptom burden,effectively improve the quality of life,improve anxiety and depression,but also improve the level of nursing satisfaction.In addition,it is also beneficial to reduce the burden of patient caregivers,improve th e knowledge level of patients and their families,and change the wrong cognition. |
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