Clinical Study On Symptom Distress Of Gynecological Malignant Tumor Patients Undergoing Chemotherapy

Objective:To investigate the understanding of the toxic and side effects of chemotherapy in patients with gynecological malignant tumor.To analyze the life troubles caused by toxic and side effects of chemotherapy to patients with gynecological malignant tumor.Methods: From March 2021 to October 2022,patients receiving chemotherapy in the gynecological ward of the First Affiliated Hospital of Dalian Medical University were investigated.A total of 83 patients were collected after inclusion and exclusion criteria screening.The collected information was statistically analyzed by SPSS 22.0 software.The frequency and component ratio methods were used for descriptive statistics of count data.The difference between groups was first compared by Mann-Whitney U test for grade data.Results:1.A questionnaire survey was conducted on patients before chemotherapy,and the results showed that there were only 3 toxic and side effects of chemotherapy with an awareness rate of more than 50%,including alopecia,gastrointestinal reaction and fatigue,while the incidence of actual toxic and side effects of chemotherapy was more than 50%,including gastrointestinal reaction,fatigue,alopecia,bone marrow suppression and numbness of hands and feet.The awareness rate of gastrointestinal reaction,fatigue,numbness of hands and feet,bone marrow suppression,pain,constipation was much lower than the actual incidence,but the awareness rate of hair loss was higher than the actual incidence(88.0%vs79.5%,P=0.141).In addition,there is a misunderstanding of irreversible toxic and side effects of patients.More than 50%of patients believe that hair loss,kidney toxicity and liver toxicity are irreversible,but in fact,these toxic and side effects can be alleviated after chemotherapy.However,the awareness rate of irreversible toxic and side effects such as numbness of hands and feet and vascular injury is lower than 50% in patients.After chemotherapy,myelosuppression,numbness of hands and feet,pain,fatigue and gastrointestinal reactions caused more serious disturbances in different aspects of life of patients than expected,while hair loss caused less disturbances in daily activities and interpersonal communication of patients than expected before chemotherapy.2.The incidence of grade 3-4 leukocytosis/neutropenia in the prophylactic pegylated recombinant human granulocyte colony-stimulating factor group was lower than that in the group without prophylactic pegylated recombinant human granulocyte colony-stimulating factor group(7.9%vs27.9%,P=0.016),and there was no difference in the distress caused by myelosuppression and fatigue symptoms between the two groups(P > 0.05).3.The severity of hair loss was different in different chemotherapy regimens.The incidence of grade 3-4 hair loss in the liposomal doxorubicin group was lower than that in the paclitaxel group(25%vs70.4%,P=0.007),thus reducing the disturbance caused by hair loss to patients.There was no difference in the severity of other toxic and side effects and the distress caused to patients between the two groups(P > 0.05).Conclusion:1.Patients have a certain understanding of the toxic and side effects caused by chemotherapy,such as gastrointestinal reactions,hair loss and fatigue,but lack of understanding of the hand and foot numbness,bone marrow suppression and other toxic and side effects,and there are also misunderstandings about the irreversibility of toxic and side effects.2.Myelosuppression,numbness of hands and feet,pain,gastrointestinal reactions,fatigue and other toxic side effects actually caused more serious distress than patients expected.3.The incidence and severity of liposomal doxorubicin alopecia is low,reducing the disturbance of hair loss to patients’ quality of life.