摘要：
Objective To investigate the symptom clusters of gastric cancer patients before chemotherapy,so as to provide a theoretical basis for the development of targeted management strategies.Methods A total of 228 gastric cancer patients who were treated in the General Surgery Department and Oncology Department of the Second Affiliated Hospital of Zhengzhou University from September 2016 to August 2017 were selected as the survey subjects by convenience sampling method.A cross-sectional survey was used to conduct a questionnaire survey.The Chinese Version Memorial Symptom Assessment Scale(MSAS)was used to evaluate the patients' symptoms before chemotherapy.Correspondence analysis was used to extract symptom clusters.Results A total of 228 questionnaires were distributed,and 224 were effective.The effective recovery rate was 98.2％.Before chemotherapy,the 5 most prevalent symptoms of gastric cancer patients were weight loss(97.8％),dry mouth(95.1％),pain(90.6％),sweating(84.4％)and lack of vitality/fatigue(79.5％).The top 5 symptoms of severity were lack of vitality/fatigue,difficult to focus,body swelling/bloating,swelling of the arms or legs and anxiety.Using the correspondence analysis to get 5 symptom clusters,the 5 symptom clusters were the energy deficiency symptom cluster,digestive tract symptom cluster,physical and mental symptom cluster,surgical related symptom cluster and neurological symptom cluster.The Cronbach's α coefficient was 0.95,0.89,0.92,0.93 and 0.87 respectively.Conclusions This study clarified the pre-chemotherapy symptom clusters of gastric cancer patients,and provided a scientific basis for exploring practical and effective methods of symptom management.At the same time,this research can also provide reference for the applicationof correspondence analysis method in the study of cancer symptom clusters.%目的 调查胃癌患者化疗前症状群,为制定针对性的症状管理策略提供理论依据.方法 采用便利抽样法,选取2016年9月—2017年8月在郑州大学第二附属医院普外科及肿瘤科治疗的胃癌患者228例为调查对象.采用横断面调查方法对患者进行问卷调查.采用中文版记忆症状评估量表(MSAS)调查患者化疗前症状发生情况,应用对应分析方法提取症状群.结果 共发放问卷228份,回收有效问卷224份,有效回收率为98.2％.化疗前,胃癌患者发生率最高的5个症状依次为体重下降(97.8％)、口干(95.1％)、疼痛(90.6％)、出汗(84.4％)、缺乏活力/乏力(79.5％).严重程度排名前5的症状依次为缺乏活力/乏力、难以集中注意力、身体肿胀/腹胀、手臂或腿部肿胀、焦虑不安.运用对应分析得出5个症状群,分别为能量不足症状群、消化道症状群、身心症状群、手术相关症状群和神经症状群,Cronbach'sα系数分别为0.95、0.89、0.92、0.93、0.87.结论 本研究明确了胃癌患者化疗前症状群,可为探索实用、有效的症状管理方法提供科学依据.同时也可为对应分析方法在癌症症状群研究中的应用提供借鉴和参考.
