Application Of Symptom Management Education In Core Symptom Cluster Of Patients With Lung Cancer Chemotherapy

ObjectiveTo construct an intervention scheme suitable for core symptom cluster of patients with lung cancer chemotherapy,and to verify the effect of the scheme on improving patients' symptom group and quality of life,and to evaluate the feasibility and effectiveness of the scheme.Methods1.Databases including Cochrane library,EMbase,Ovid and cnki were retrieved.The search was conducted from 2001 to August 2018.To collect and statistically analyze the effect of symptom management education on improving symptom cluster of cancer patients.2.According to the results of systematic evaluation,an intervention scheme was constructed for the symptom cluster of cough,fatigue and dyspnea in patients with lung cancer chemotherapy.Based on the method of expert meeting,opinions and suggestions of experts were collected,and the intervention plan was revised in combination with the preliminary experiment.3.Based on the design of a controlled experimental study of the same period,two respiratory departments in a hospital in zhengzhou were selected as the researchunits.The experimental group received educational intervention of symptom management,and the control group received routine nursing care.General data questionnaire,cough score scale,cancer treatment-related fatigue function evaluation scale,cancer dyspnea scale and quality of life core scale were used to evaluate the effect of intervention on improving symptom group and quality of life of patients with lung cancer chemotherapy.Results1.Meta analysis showed that symptom management education can effectively improve pain,fatigue,sleep disorder symptom cluster,digestive system symptom cluster and psycho-cognitive symptom cluster in cancer patients;However,there was no statistical significance in improving the quality of life of patients(P>0.05).There is a lack of research on whether it can improve cough,fatigue and dyspnea symptom cluster in patients with lung cancer.2.The intervention program includes three parts: cough,fatigue and dyspnea management;The manual of symptom management was used as assistant tool,and one-to-one bedside intervention was adopted.The duration was 6 cycles of chemotherapy,and intervention was conducted before chemotherapy,with each intervention lasting 30~60min.3.Intervention study results:(1)A total of 90 cases of lung cancer patients with chemotherapy were included,45 cases in the intervention group and 45 cases in the control group.After the intervention,39 patients in the intervention group had a retention rate of 86.7 %.The control group had 38 patients,with a retention rate of 84.4 %.(2)In terms of improving the effect of symptom cluster,the main effect of the intervention of cough symptom score was not statistically significant,while the main effect of the intervention of fatigue and dyspnea symptom score was statistically significant(P < 0.05).There was no significant difference in scores of nocturnal cough.The time main effect of daytime cough,fatigue and dyspnea symptom score was statistically significant(P<0.05).There was an interaction between the time andintervention factors of fatigue and dyspnea(P<0.05).(3)In terms of the effect of improving the quality of life of patients,the results showed that the main effect of the intervention was statistically significant in terms of social function,fatigue,nausea and vomiting,sleep disorder,dyspnea,and appetite loss.The time main effect of body function and economic difficulty score was statistically significant.There was an interaction effect between the time factors of overall quality of life,body function,social function and appetite decline score and the intervention factors(P<0.05).ConclusionSymptomatic management education intervention is helpful to improve the core symptom cluster and quality of life of patients with lung cancer chemotherapy,alleviate cough,fatigue and dyspnea symptoms of patients,and improve the overall quality of life of patients,but the effect of this intervention program on improving cough symptoms of patients is not statistically significant.During the intervention,the subjects had good compliance and no adverse events occurred,so it is suitable to be popularized in patients with lung cancer chemotherapy.