The Study Of The Effect About Life Activities Function In Cancer-related-symptom Clusters For Esophageal Patients To Receive Radiotherapy

Objective: Cancer patients during radiotherapy as the research objectwere selected in this study, with qualitative research method to explore anddescribe the true feeling of patients in radiotherapy, deep understand theemotional journey of cancer-related-symptom clusters with cancer patients;Combined the quantitative study, analysis symptom clusters of radiotherapyprocess, discuss the phenomenon of symptom clusters and correlation betweenthe symptoms, explore the severity of symptom clusters and the influence ofthe patients' life, can help clinical staff to provide effective care for cancerpatients in period of radiotherapy, and then improve the function of life of theesophageal patients.Methods: Meet the criteria of esophageal cancer patients in radiotherapy,10cases were selected as the purposive sampling, use qualitative study, thephenomenological method of the qualitative study is the theoretical guidance,pass the informal conversations, in-depth interviews to collect data.100patients were selected as the sampling in the quantitative study, it isthe cross-sectional and descriptive study, apply the M.D. Anderson symptomsurvey of Chinese to evaluate. Finally, SPSS software for windows version18.0was applied to analyze the data.Results:The results of qualitative study of Cancer-related-symptom clusters ofesophageal cancer patients:Pass the interview, qualitative study found that the cancer patients havecancer-related-symptom clusters during radiotherapy. Finally, produced a corecategory and six major categories. 1Core category: the influence on feeling of psychological factors andCancer-related-symptom clusters.2Major categories:2.1Emotional experience: include shock and denial, anxiety, depression,complaint and anger.2.2Faith and self-expectations: include the faith can affect the outcome ofradiotherapy of cancer-related-symptom clusters, acquisition of helpless, andthe treatment of contradiction.2.3Attribution: include disease attribute to geographic areas and diseaseattribute to fate.2.4Coping strategies: include negative coping, active coping.2.5Unpredictable results: include the worry and fear of diseases andthe unpredictable disease outcome.2.6The relation between the symptom clusters: include the swallow difficult,the change of symptom clusters after radiotherapy over time, and thecorrelation between the symptoms.The results of quantitative study:1In the past24hours, the top three serious items of the symptoms is lack ofappetite, fatigue, dry mouth. The three items of the influence about thefunction of the patients' life is the work, general activity, enjoyment of life.2The change of the severity about symptoms in5different periods inradiotherapy,<5times, lack of appetite is the most severity;6~9times, fatigueis the most severity,10~15times, dry mouth is the most severity,16~19times,dry mouth is the most severity,>20times, fatigue is the most severity. In5periods, during>20times, the total mean score of symptoms is the highest, is(50.67±28.01); the mean total numbers of the symptoms is (9.63±2.88),themean symptoms' number is the largest.3The correlation between the symptoms of the symptom clusters, the resultsshow that between nausea and vomiting is the highest related, related value is0.712(p<0.01); follow by sad and distress, drowsy and distress. 4Apply Spearman correlation analysis indicated that between the total scoreof symptoms, the number of symptoms and interference of the life activitieshave correlation.5Apply multiple regression analysis indicated that the following factors cansignificantly influence the life activities of patients, they were the times ofradiotherapy, the numbers of complications, and religion.6Apply factor analysis indicated that the drowsy, pain, fatigue, dry mouth,distress, lack of appetite form the first component, named for the [feedingrelated factors] symptom clusters; nausea and vomiting form the secondcomponent, named for the [gastrointestinal related factors] symptom clusters;remembering things and shortness of breath form the third component, namedfor the [body function related factors] symptom clusters.7Apply clustering analysis indicated that nausea, vomiting, sad, numbness ortingling, shortness of breath, remembering things form a category; Fatigue,lack of appetite, pain, distress, disturbed sleep, drowsy, dry mouth form another category.Conclusion:1The conclusion of the qualitative studyEsophageal cancer patients have cancer-related-symptom clusters duringradiotherapy. Core category is the influence on feeling of psychologicalfactors and cancer-related-symptom clusters. Cancer-related-symptom clusterscan affect the function of patients' life, reduce the life quality of patients. If weeffectively identify and manage these symptom clusters, can reduce the burdenof cancer patients' symptoms, improve the life quality of cancer patients.2The conclusion of the quantitative studyResearch results showed that esophageal cancer patients not only have asingle of the symptom, but also these symptoms often gathered into a clusters,common influence the function of patients, form cancer-related-symptomclusters. Factor analysis shows that cancer-related-symptom clusters havethree components. Cancer patients have the phenomenon of symptomsclustering in radiation process, after clustering analysis, form two major symptom clusters. Cancer patients' symptoms have different severity indifferent stage during radiotherapy, cancer patients' symptoms influence thefunction of the patients' life. Between the symptoms have correlation insymptom clusters.