Study On The Symptom Clusters And Resilience Of Patients With Cervical Cancer During Radiotherapy And Chemotherapy

Objectives1.To investigate the resilience and symptom clusters during the treatment of cervical cancer patients.2.To explore the correlation and influencing factors of resilience and symptom clusters during the treatment of cervical cancer patients.3.To explore the measures to improve the psychological elasticity and relieve the symptoms of cervical cancer patients during the treatment.Methods1.A cross-sectional study is conducted.A best hospital with gynecologic oncology specialist in Jing Zhou,Hubei province is selected as the investigation site.128 cases of eligible cervical cancer patients are selected as the research objects by the convenience sampling method.2.A self-made "general survey table" is used to collected the clinical data and basic information of patients with cervical cancer during the treatment.By Chinese version of the Connor-Davidson Resilience Scale toughness(CD-RISC)the resilience score of patients with cervical cancer during the treatment and scores in hardiness dimension,strength dimension and optimism dimension are got.The Chinese version Memorial Symptom Assessment Scale,(MSAS-Ch)is used to evaluate symptom groups of cervical cancer patients during chemotherapy.Results1.The total score of psychological resilience of cervical cancer patients is 57.77±9.41 points,the resilience dimension score is 28.76±5.56 points,the strength dimension score is 19.60±4.32 points,and the optimism dimension score is 9.45±1.93 points.There are statistical differences in psychological resilience score between different age,educational level,income level,whether patients with chronic disease or with tumor metastasize,and different surgical methods for cervical cancer patients.2.The symptoms with the top three frequencies are "the lack of activity / weakness"(88.3%),"I don’t look like myself"(79.7%)and sad(78.9%);symptom severity scores range from dysphagia(0.03±0.15 points)to "the lack of activity / weakness"(1.93±0.91points).The top three symptoms of severity score are "lack of activity / fatigue",followed by feeling "I don’t look like myself"(1.80±1.53 points),alopecia(1.71±1.30points),nausea(1.63±1.13 points)and vomiting(1.57±1.15 points).The first three symptoms with the lowest frequency and the lowest severity during treatment aredysphagia(4.7%,0.06±0.30 points),tightness or dyspnea(4.7%,0.05±0.21 points),dysphagia(3.1%,0.03±0.15).Four symptom groups are precipitated,which are negative emotional symptom group,mental body symptom group,treatment side effect group and sickness behaviour symptom group.The negative emotional symptom group has the highest frequency.3.That resilience scores of cervical cancer patients are included in multivariate linear regression analysis as the dependent variables,showed that the independent variables into the regression equation are the degree of cultural [B=-3.089,95%CI(-4.766,-1.412)],the monthly income [B=3.384,95%CI(1.449,5.318)],the age [B=2.815,95%CI(1.147,4.482)],treatment B=-3.145 95%CI,(-6.102,-0.206)],and whether tumor metastasis [B=-4.622,95%CI(-8.953,-0.292)].4.The relation between resilience score and negative psychological symptoms(r=-0.904,p<0.01),the body of psychiatric symptoms(r=-0.473,p<0.01)group,side effects of treatment of symptoms(r=-0.397,p<0.01),sickness behaviour symptoms are negatively correlated(r=-0.303,p<0.01).And each dimension of resilience is negatively correlated with each symptom group.Conclusions1.The Resilience of the patients with cervical cancer is lower than the average mental resilience level of the domestic healthy adults and lower than the mental resilience of the foreign cancer patients.It is suggested that the medical staff should pay attention to the Resilience of the patients with cervical cancer during the treatment.2.Factors influencing the resilience of cervical cancer patients include education level,monthly income,age,treatment mode,tumor metastasis and others.It suggests that medical staff should take effective measures within the enforceable scope to promote the Resilience level of cervical cancer patients.3.The study gets the four precipitation symptom groups,including psychological and physiological symptoms.The negative psychological symptoms have the highest frequency,which suggests that the medical staff should fully understand their symptoms of the cervical cancer patients during treatment.The medical staff should not only do treatment related symptoms,but also take timely and effective psychological counseling and support therapy for the remission of patients with negative emotions.Reduce the symptoms of discomfort during the treatment of the patients,promote their comfort,and improve the sense of experience during the radiotherapy and chemotherapy.