Analysis Of Influencing Factors Of Symptom Clusters In Chemotherapeutic Patients With Lung Cancer And Its Correlation With Common Blood Parameters

ObjectiveTo investigate symptom and symptom cluster of lung cancer patients during their chemotherapy and discuss the correlation between blood parameters and the symptom cluster of lung cancer patients who’s undergoing chemotherapy.To explore the influence of changes of blood parameters on symptom cluster.To provide a more objective and easy-to-obtain reference index for the evaluation of symptom management.To provide reference basis for the formulation of intervention measures of symptom cluster in patients with lung cancer undergoing chemotherapy.MethodsA convenient sampling method was used to extract lung cancer patients who’s hospitalizing and undergoing chemotherapy from Oct.2017 to Aug.2018 at Grade A tertiary hospitals.A total of 667 patients completed a self-made general information questionnaire and the Chinese version of the M.D.Anderson Symptom Inventory-Lung cancer inventory.Factor analysis and Cluster analysis were used to confirm the type of symptom clusters.Partial least square model were used to explore and analyze the influencing factors of symptom group and its correlation with common blood parameters in patients with lung cancer during chemotherapy.Results(1)The prevalence of lung cancer patients,who had symptom,ranged from 46.2% to 98.7% in the investigation.The five most severe symptoms were fatigue,nausea,chest tightness,poor appetite,and expectoration,respectively.Symptom distress Incidence of the lung cancer patients is more than 90%.The patients’ mood and enjoyment of life were the most influent factors for their daily life.(2)In exploratory factor analysis and variable clustering analysis of results show that finally four clusters were identified.According to the characteristics of symptoms included in the final results of exploratory factor analysis and variable clustering analysis,The four symptom clusters represented were named as “respiratory symptom cluster”,“gastrointestinal symptom cluster”,“Sickness symptom cluster” and “psychological symptom cluster”.The incidence of all symptom clusters was over 80%,and the highest incidence was gastrointestinal symptom cluster(97.00%).The severity of symptom cluster in lung cancer patients during chemotherapy is mainly mild to moderate.respiratory symptom cluster are most severe.(3)Stepwise regression analysis was used to understand the influence of general information of patients on each symptom group of lung cancer patients during chemotherapy.The influencing factors of respiratory symptoms were metastasis;The influencing factors of gastrointestinal symptoms were duration of chemotherapy and duration of illness;The influencing factors of sickness symptoms were family income and TNM stage;The influencing factors of emotion-related symptoms were age,occupational family monthly income and chemotherapy cycle(P<0.05).Partial least square model were used to understand the influence of blood parameters on each symptom group of lung cancer patients during chemotherapy show that the cumulative percentage of variation for blood parameters in the gastrointestinal symptom cluster,psychological symptom cluster,respiratory symptom cluster and sickness symptom cluster were 34.66%,29.27%,20.60% and 20.29%,respectively.Thrombocyte(VIP=3.295)and thrombin time(VIP = 4.031)had significant effects on respiratory symptom cluster.Serum calcium(VIP = 4.101)and serum potassium(VIP=4.502)had significant effects on gastrointestinal symptom cluster.White blood cell(VIP=2.974)and hemoglobin(VIP=4.048)had significant effects on sickness symptom cluster.Serum magnesium(VIP=4.376)had significant effects on psychological symptom cluster.(4)Correlation analysis were used to understand the relationship between blood parameters and various symptom cluster of patients with lung cancer chemotherapy show that the respiratory symptom cluster is positively correlated with thrombin time(r = 0.596,P < 0.001)and negatively correlated with thrombocyte(r =-0.428,P < 0.001);the gastrointestinal symptom is positively correlated with serum calcium(r=0.713,P<0.001)and negatively correlated with serum potassium(r=-0.790,P<0.001);the sickness symptom cluster is highly negatively correlated White blood cell(r=-0.407,P<0.001),hemoglobin(r=-0.492,P < 0.001);The psychological symptom cluster is negative correlated with serum magnesium(r=-0.542,P<0.001).Conclusion(1)The lung cancer patients undergoing chemotherapy was at mild level,higher incidence and multiple symptoms.The lung cancer patients during chemotherapy exist multiple symptom cluster respiratory symptom cluster,gastrointestinal symptom cluster,sickness symptom cluster and psychological symptom cluster.the severity of which was mainly mild to moderate and higher incidence(84.25%–97.00%).(2)The sociological data and clinical tumor-related characteristics can affect the severity of the symptom cluster of chemotherapy patients with lung cancer.there are also were affected by a variety of blood indicators.(3)The severity of symptom cluster in patients with lung cancer was positively correlated with thrombocyte and serum calcium,and negatively correlated with thrombin time,white blood cell,hemoglobin content and serum magnesium.