| Objective: To construct a symptom assessment scale suitable for esophageal cancer patients in China for the actual condition of esophageal cancer patients,and to provide a scientific basis for symptom evaluation and symptom management of esophageal cancer patients.This scale is used in clinical practice to explore patients with postoperative chemotherapy for esophageal cancer.(T1),after three cycles after chemotherapy(T2),six cycles after chemotherapy(T3),the frequency,intensity and composition of symptom clusters provide a basis for clinical staff to carry out scientific symptom management.Methods: This study was divided into two parts.The first part was the construction of the symptom assessment scale for esophageal cancer patients.The documentary study combined with interviews with esophageal cancer patients,clinical staff and group discussions and preliminary establishment of symptoms assessment scale for esophageal cancer patients.Pool,using Delphi expert consultation method to assess the scale items,and collecting 239 cases of esophageal cancer patients by convenient sampling method,using the content validity,internal consistency Cronbach’ a coefficient and test-retest reliability to evaluate the scale reliability and validity.The second part is a prospective longitudinal study.Patients with esophageal cancer were surveyed at three time points using a general condition scale,an esophageal cancer condition assessment scale,and a Kamossky performance assessment scale(KPS)questionnaire.Analyze and process the data,use the mean,standard deviation,percentage to describe the patient’s general data,frequency and severity of symptoms;use exploratory factor analysis to analyze the composition of symptom cluster,longitudinal analysis of patients with esophageal cancer at different time points Symptom changes.Results:1 After two rounds of expert consultation,the “Evaluation Scale for Esophageal Cancer Patients” was established after formal investigation.There were 31 items in the scale,and 8 common factors were extracted by exploratory factor method.The cumulative variance contribution rate was 73.091%.The Cronbach’s α coefficient of the scale is 0.878,and the Cronbach’s α coefficient of each factor is between 0.722 and 0.937.The internal consistency of the questionnaire is good.2 In the longitudinal study of symptom clusters of postoperative chemotherapy patients with esophageal cancer,a total of six symptom clusters were obtained at three time points,namely,eating difficulty symptom cluster,Gastrointestinal symptom cluster,psychological symptom cluster,energy deficiency symptom cluster,and reflux cough symptoms cluster,neurotoxic symptom cluster.(1)At T1,four symptom clusters were obtained: eating difficulty symptom cluster,including dysphagia(2.14±1.08),eating pain or discomfort(1.42±0.83),satiety after eating(1.33±0.97),appetite The decrease was(1.54±0.93)and the hoarseness was(1.27±1.04),and the incidence rates were 48.35%,42.86%,40.66%,51.65%,42.86%,respectively.Energy deficiency symptom cluster,including pain(1.43 ± 0.98),fatigue(1.84 ± 0.48),shortness of breath(1.32 ± 0.77),weight loss(2.01 ± 0.67),sleep disorders(1.72 ± 0.78),the incidence rate was 69.23%,85.71%,45.05%,78.02%,73.63%.Gastrointestinal symptom cluster,including hernia(1.33 ± 1.15),heartburn(1.67 ± 0.74),constipation(1.13 ± 0.93),the incidence rate was 51.65%,34.07%,24.18%.Reflux cough symptom cluster,including reflux(1.76 ± 0.84),cough(1.82 ± 0.71),dry mouth(1.36 ± 0.92),the incidence rate was 48.35%,56.04%,64.84%.(2)A total of 5 symptom clusters at T2 time: eating difficulties symptom cluster,including dysphagia(2.03±0.76),eating pain or discomfort(1.78±0.83),satiety after eating(1.46±0.91)),weight loss(1.66 ± 1.04),hoarseness(1.12 ± 1.01),the incidence rate was 46.15%,48.35%,51.65%,43.96%.Energy deficiency symptom cluster,including fatigue(2.31 ± 0.92),pain(1.72 ± 0.68),dizziness(1.31 ± 0.70),shortness of breath(1.15 ± 0.56),sleep disorders(1.56 ± 1.13),the incidence rate was 75.82%,46.15%,40.66%,39.56%,46.15%.Gastrointestinal symptom cluster: hernia(1.49±1.02),heartburn(1.27±0.73),constipation(1.35±0.93),loss of appetite(2.21±0.86),nausea(1.92±0.93),vomiting(1.13±0.94),Dry mouth(1.52±0.71),the incidence rate was 49.45%,37.36%,30.77%,51.65%,67.03%,25.27%,67.03%.Psychological symptom cluster,including anxiety(1.53±0.93),irritable irritability(1.22±0.54),alopecia(1.35±0.82),and sadness(1.17±0.69),the incidence rate was 48.35%,24.17%,26.37%,28.57.%.reflux cough symptom cluster,including cough(2.16±0.97),reflux(1.92±0.71),and taste change(1.27±0.88),the incidence rates were 62.64%,51.65%,and 29.67%,respectively.(3)There were 6 symptom cluster at T3 time: eating difficulties symptom cluster,including dysphagia(1.98±0.62),eating pain or discomfort(1.36±0.54),satiety after eating(1.57±0.68),nausea(2.31±0.84),weight loss(1.75±0.51),hoarseness(1.22±0.93),the incidence rate was 40.66%,51.65%,52.75%,71.42%,83.52%.Energy deficiency symptom cluster included pain(1.38±0.62),fatigue(2.41±0.89),and sleep disturbance(1.48±1.03),and the incidence rates were 37.36%,91.21%,and 64.84%,respectively.Gastrointestinal symptom cluster,including hernia(1.17±0.92),heartburn(1.36±0.48),vomiting(1.38±0.99),constipation(1.31±0.85),the incidence rates were 52.75%,36.26%,32.97%,38.46%,respectively.Reflux cough symptom cluster,including changes in taste(1.69±0.71),dry mouth(2.02±0.83),cough(1.79±0.53),reflux(1.87±0.65),the incidence rates were 34.07%,46.15%,45.05 %.Psychological symptom clusters,including anxiety(1.75±0.61),irritable irritability(1.09±0.23),sadness(1.32±0.58),alopecia(1.22±0.91),shortness of breath(1.46±0.67),the incidence rate was 58.24%.,38.46%,34.07%,48.35%.Neurotoxicity Symptom cluster,including numbness or acupuncture(1.19±0.31),oral ulcers(1.35±0.48),and dizziness(1.57±0.76),the incidence rates were 24.28%,28.57%,and 45.05%,respectively.Conclusion:1 The "Esophageal Cancer Symptom Assessment Scale" was constructed,showing good reliability and validity and suitable for clinical application.2 Patients with esophageal cancer have more symptoms and a higher incidence.The patient bears a serious burden of symptoms.In clinical work,the symptom burden of esophageal cancer patients should be evaluated and managed.3 The number of symptom clusters at different time points of chemotherapy is different from that of constituent components.There are 4 atT1,5 at T2,and 6 at T3.Among them,eating difficulty symptom cluster,Gastrointestinal symptom cluster,energy deficiency symptom cluster,and reflux cough symptoms cluster runs through the entire process of chemotherapy. |
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