| Objective The purpose of this study was to investigate the prevalence of frailty in cancer patients during chemotherapy,analyze the relationship between frailty and symptoms,anxiety and depression,and social support,explore the possible factors affecting the frailty of cancer patients during chemotherapy,identify the high-risk groups of cancer patients during chemotherapy,and provide the basis for future nursing intervention.Methods From October 2017 to May 2018,inpatients with cancer in three general hospitals in Suzhou were selected by convenience sampling.The inclusion criteria were:patients who were diagnosed as cancer by pathology or cytology and were currently receiving chemotherapy,aged ≥(18 years)and were aware of their condition,conscious,able to communicate normally,and informed consent and completed the questionnaire.The questionnaires were distributed and retrieved by the researchers on the spot.The instruments used included general information questionnaire,clinical frailty scale,Anderson symptom inventory,Hospital Anxiety and depression scale and social support rating scale.Questionnaires were collected and entered into Excel,a database was established,and data were analyzed and processed by SPSS 20.0 software.The statistical methods included chi-square test,t-test,rank sum test,which were used to analyze patients’general data,symptom groups,anxiety and depression levels,social support levels and frailty.Two yuan Logistic was used to analyze the risk factors of cancer patients’asthenia.Result1.A total of 240 questionnaires were sent out,220 valid questionnaires were collected,and the effective rate of the questionnaire was 91.7%.2.Of the 220 patients with chemotherapy-induced cancer,148(67.3%)were diagnosed as frailty,95(43.2%)were mild frailty,51(23.2%)were moderate frailty,and 2(0.9%)were severe frailty.3.The results of this study showed that the symptoms with the highest incidence of cancer during chemotherapy and the symptoms with the highest score were fatigue,with a symptom score of(7.44±1.79)and a incidence of 99.5%.After exploratory factor analysis,13 symptoms were eventually classified into 3 symptom groups,namely "neurosomatic symptoms group","digestive tract symptoms grou" and " emotional and fatigue symptoms group".The symptoms had the greatest disturbance to work(including housework)(8.64 ± 1.85)and the lowest disturbance to relationship with others(4.44±2.89).4.In this study,the total score of Hospital Anxiety and depression scale was(18.28±8.10),the score of anxiety subscale was(8.63±4.05),and the score of depression subscale was(9.65±4.29).5.The total score of social support was(39.52±6.75),subjective support(21.06±3.84),objective support(11.24±1.78)and utilization of support(7.22±2.44).6.Univariate analysis showed that age,educational level,family monthly income,disease diagnosis,course of disease,clinical stage,metastasis,type of operation,hemoglobin concentration,white blood cell count,albumin concentration,neurosomatic symptom group score,emotional and fatigue symptom group score,HADS total score,anxiety sub-scale The scores of depression subscale,total social support objective support and utilization of support were related to the occurrence of frailty(P<0.05).However,there was no significant difference in gender,occupation,marital status,living condition,family income,medical expenses,chemotherapy course,concomitant diseases,BMI index,digestive tract symptom group,subjective support of patients(P>0.05).7.Multivariate logistic regression analysis showed that the risk factors associated with the occurrence of frailty in cancer patients during chemotherapy included hemoglobin concentration,white blood cell count,neurosomatic symptoms,emotional and fatigue symptoms and depression sub-scale scores.Hemoglobin concentration greater than 120 g/L,white blood cell count greater than 4×10 9/L is a protective factor for the occurrence of frailty.The scores of neurosomatic symptoms,emotional and fatigue symptoms and depression subscale were the risk factors of frailty.ConclusionCompared with the incidence of senile cancer patients abroad,this study shows that the incidence of senile cancer patients with chemotherapy is higher.The main factors affecting the frailty of cancer patients during chemotherapy are hemoglobin concentration,white blood cell count,neurosomatic symptoms,emotional and fatigue symptoms and depression.Clinicians and nurses should pay more attention to these high-risk factors,early identification,and early intervention in the prevention of debilitation. |
