Study On Symptom Clusters And Its Influencing Factors In Postoperative Patients With Gastric Cancer

Objectives Investigate the symptoms of postoperative patients with gastric cancer and explore the types of symptom clusters in postoperative patients with gastric cancer.To analyze the influencing factors of symptom clusters in postoperative patients with gastric cancer and provide evidence basis for establishing effective symptom management mode and nursing intervention measures.Methods From October 2016 to September 2017,the patients with gastric cancer from three three Grade A hospital in Shijiazhuang City were studied,and the Chinese version of the Anderson Symptom Scale(MDASI-C)was used to evaluate the symptoms of patients on the 7th day after gastric cancer operation.Methods of exploratory factor analysis were used to explore the types and composition of symptom clusters in postoperative patients with gastric cancer.The questionnaire was used to investigate the factors influencing the symptom clusters in postoperative patients with gastric cancer.The questionnaire included demographic data,disease and treatment related data,social support level and psychological factors of anxiety and depression in patients.After a single factor analysis of the severity of postoperative patients with gastric cancer,a multivariate linear regression analysis was carried out to select the factors influencing the symptom clusters of postoperative gastric cancer patients.Results 1 The analysis of symptom and symptom clusters in postoperative patients with gastric cancer showed: the higher incidence of symptom was appetite difference(99.5%),fatigue(98.1%),dry mouth(96.7%)and nausea(96.7%).The severity scores of symptoms were in order of appetite difference(6.00 points),dry mouth(6.00 points)and fatigue(5.00 points).Through exploratory factor analysis,3 types of symptom clusters were found,which were fatigue related symptom cluster,gastrointestinal related symptom cluster,emotion-appetite related symptom cluster.2 The results of single factor analysis of symptom clusters in postoperative patients with gastric cancer showed: age,sex,marital status,working status,household per capita monthly income,medical expenses payment mode,education level,smoking history,clinical staging,operation method,tumor location,accompanying disease number,physical status score,social support,anxiety,16 factors of depression were related to the severity scores of fatigue related symptom cluster,the differences were statistically significant(p<0.05).Age,sex,marital status,working status,smoking history,household per capita monthly income,education level,clinical staging,surgical methods,tumor location,accompanying disease number,physical status score,social support,15 factors of anxiety and depression were related to the severity score of gastrointestinal related symptom cluster,the differences were statistically significant(p<0.05).Age,sex,marital status,working status,household per capita monthly income,medical expenses payment method,education level,smoking history,medical expenses payment method,clinical staging,operation method,tumor location,accompanying disease number,physical status score,social support,anxiety,depression 16 factors were related to the severity scores of emotion-appetite related symptom cluster,and the difference was statistically significant(p<0.05).3 The results of multifactor analysis of symptom clusters in postoperative patients with gastric cancer showed: the influencing factors of fatigue related symptom cluster were age,physical status score and operation method.The factors influencing the gastrointestinal related symptom cluster were sex,education,social support,depression,anxiety,marital status and monthly income percapita of the family.The influencing factors of emotion-appetite related symptom cluster were social support,age,payment mode of medical expenses,smoking history and working status.Conclusions 1 There are 3 types of symptom clusters in postoperative patients with gastric cancer,namely fatigue related symptom cluster,gastrointestinal related symptom cluster,and emotion-appetite related symptom cluster.2 The influencing factors of fatigue related symptom cluster were age,physical fitness status score and operation method.The influencing factors of gastrointestinal related symptom cluster were sex,educational level,social support,depression,anxiety,marital status and monthly income per capita of the family.The influencing factors of emotion-appetite related symptom cluster were social support,age,Medical expenses payment method,smoking history and working status.