肺癌术后化疗病人症状群测评问卷的编制与现状调查

马景双，王爱平

摘要：[目的]编制肺癌术后化疗病人症状群测评问卷；运用此问卷调查肺癌术后化疗病人症状分布特征及影响因素。[方法]在文献回顾及半结构访谈和专家评定的基础上形成32个条目的初始化问卷；对90例肺癌术后化疗病人进行问卷调查，采用因子分析检验问卷的结构效度；应用欧洲癌症研究与治疗组织研制的第3版中文版生活质量核心调查问卷和抑郁自评量表检验问卷的效标关联效度；采用Cronbach’s α系数来检验内部一致性信度；1周后再次发放10份问卷,测量两次的Spearman相关系数验证其重测信度；通过多元逐步回归分析，探讨肺癌术后化疗病人症状的影响因素。[结果]因子分析提取3个因子,累计贡献率为52.09%；欧洲生命质量协作组癌症核心量表和抑郁自评量表与肺癌术后化疗病人症状群测评问卷之间的相关系数分别为-0.664,0.457(P<0.01)；总问卷的Cronbach’s α系数为0.909,3个维度的Cronbach’s α系数为0.744～0.908；问卷总分的重测相关系数为0.721; 肺癌术后化疗病人的所有症状中，疲乏发生率和严重度居首，脱发仅次于疲乏；多元逐步回归分析显示，性别、化疗周期是肺癌术后化疗病人症状的影响因素。[结论]所研制的肺癌术后化疗病人症状群测评问卷具有较好的信度和效度，可作为临床肺癌化疗病人症状的有效测量工具；护理人员应采取针对性护理措施，降低疲乏和脱发发生率和严重度；同时加强女性病人及化疗晚期病人的健康教育，减少症状发生率，提高生命质量。

关键词：肺癌；化疗；测评问卷；症状；信度；效度；影响因素

中图分类号：R473.73

作者简介：马景双，护师，硕士研究生，单位：110001，中国医科大学附属第一医院；王爱平(

收稿日期：(2014-03-27；修回日期：2014-12-18)

Survey of preparation and status quo of symptom clusters assessment questionnaire for lung cancer patients receiving postoperative chemotherapy

Ma Jingshuang，Wang Aiping(Affiliated First Hospital of China Medical University，Liaoning 110001 China)

AbstractObjective：To develop a symptom clusters assessment scale for lung cancer patients who are undergoing chemotherapy after receiving surgery and to investigate the prevalence and distribution charactistics and influencing factors of symptom clusters in patients with lung cancer undergoing postoperative chemotherapy.Methods：On a basis of literature review and semi-interviews with lung cancer patients，preliminary questionnaire which contain 32 items was shaped after experts consultation.Totally 98 lung cancer patients were investigated with the questionnaire.Structure validation was validated by factor analysis．Criterion correlation validation was completed by correlation analysis between symptom assessment scale for lung cancer patients who are undergoing chemotherapy after receiving surgery and European Organization for Research on Treatment of Cancer：Quality of life questionnaire：Core30-v3.0 and Self-rating Depression Scale separately．Internal consistency reliability was validated by coefficient of Cronbach’ a．Retest reliability was validated by the correlation coefficient,the data of which was from results of 10 patients in the first survey and the second survey after One week．Regression analysis were conducted to find the factors relevant to symptoms of lung cancer patients who are undergoing chemotherapy．Results：Factor analysis produced 3 factors which accounted for 52.09%of the variance．The correlation coefficient between symptom assessment scale for lung cancer patients who are undergoing chemotherapy after receiving surgery and European Organization for Research on Treatment of Cancer：Quality of life questionnaire：Core30-v3.0 and Self-rating Depression Scale respectively were -0.664，0.457(P<0.01)．The coefficient of Cronbach’a for the total questionnaire was 0.909 and the coefficient of Cronbach’a for each dimension were 0.744～0.908．The re-test correlation coefficient was 0.721 between total questionnaires．Fatigue was the most common symptom ,and also the most serious symptom ,alopecia was the second.Multiple regression analysis revealed the gender and chemotherapy period were contributing factors.Conclusion：The symptom clusters assessment scale for lung cancer patients who are undergoing postoperative chemotherapy has good validation and reliability，which could be used as an effective tool for symptom measurement for lung cancer patients．Nurses should adopt effective nursing interventions to reduce the incidence of fatigue and alopecia.Female patients and patients who are in the later period of chemotherapy should be given special focus and provided health education to achieve better quality of life.

Key wordslung cancer；chemotherapy；assessment questionnaire；symptoms；reliability；validity；influencing factors

肺癌是胸部常见的恶性肿瘤，严重威胁着人类健康。其发病率逐年升高，临床表现隐匿，病人就诊时常为中晚期。化疗在肺癌治疗过程中起着非常重要的作用，但是化疗常使病人产生多种身心症状，使病人经历躯体和精神方面的症状困扰，并且与其他癌症病人相比，肺癌化疗病人在化疗期间经历更多的症状困扰，如疲乏、无力、呼吸困难、食欲下降、恶心、呕吐等[1，2]。……