| [Objective]Objective to clarify the change track of main chemotherapy related symptoms(MCRs)in breast cancer patients,and to clarify the influence factors of MCRs change track in breast cancer patients,so as to provide reference for the development of targeted intervention strategies.[Methods]1.Longitudinal study on the change track of main chemotherapy related symptoms in breast cancer patientsThe main chemotherapy related symptoms(MCRs)of breast cancer patients were evaluated weekly by patient reported outcomes measurement system burst chemotherapy(PROMIS-B-C).The total change trend of each MCRs was analyzed by repeated measurement variance analysis,and the growth mix modeling(GMM)was used to fit the potential categories of each MCRs development trajectory of breast cancer patients.2.Analysis of predictors of major chemotherapy-related symptoms in breast cancer patientsLogistic regression was used to analyze the differences between the baseline data of demographic,sociological and disease-related factors of different potential categories of breast cancer patients,and to screen the predictors of MCRs trajectory.[Results]1.Longitudinal study on the change track of main chemotherapy related symptoms in breast cancer patientsIn this study,the chemotherapy cycles for breast cancer patients mainly included four cycles and eight cycles.(1)The changes of fatigue in patients with breast cancer during chemotherapyThe overall trend of fatigue in patients with four cycle chemotherapy was first up and then decreased,reaching the peak in the third cycle.The growth mixed model(GMM)analysis showed that the fatigue change track of patients with four cycle chemotherapy was divided into low fatigue group(12.8%),moderate fatigue group(73%)and high fatigue group(14.2%).The fatigue change track of eight cycle chemotherapy patients with breast cancer was increasing gradually.GMM analysis showed that the fatigue change track of eight cycle chemotherapy patients was divided into fatigue change growth group(44.3%),high fatigue growth group(49.7%)and low fatigue growth group(5.9%).In a single chemotherapy cycle,the fatigue level of breast cancer patients reached the peak in the first week of chemotherapy,and then gradually decreased,but it did not recover to the pre chemotherapy level before the next chemotherapy;GMM analysis confirmed three potential categories,namely,mild fatigue change group(69.6%),moderate fatigue change group(20.5%)and severe fatigue change group(9.9%).(2)The changes of pain in patients with breast cancer during chemotherapyGMM analysis showed that the pain change trajectory of breast cancer patients with four cycles of chemotherapy was divided into three groups:pain decline group(32.2%),low pain group(49.9%)and pain change group(17.9%).The pain level of breast cancer patients in the fourth cycle was the lowest,and it increased in the fifth and sixth cycles and then decreased again.Three potential categories were identified by GMM analysis,which were fatigue pain reduction group(24.9%),pain change group(32.5%)and low pain group(42.6%).(3)The changes of anxiety in patients with breast cancer during chemotherapyThe overall change trend of anxiety of breast cancer patients after four cycles of chemotherapy was gradually decreasing,GMM analysis showed that the anxiety trajectory of breast cancer patients with four cycles of chemotherapy was divided into anxiety rising group(23.5%)and anxiety decreasing group(76.5%).According to GMM analysis,three potential categories were identified,which were anxiety rising group(28.6%),high anxiety group(10.4%)and low anxiety group(61.0%).(4)The change of depression in breast cancer patients during chemotherapyThe overall change trend of depression in breast cancer patients with four cycles of chemotherapy was gradually increasing.GMM analysis showed that the depression trajectory of breast cancer patients with four cycles of chemotherapy was divided into depression rising group(4.7%),low depression group(67.2%),high depression group(12.5%)and depression declining group(15.6%).The overall change trend of depression in breast cancer patients with eight cycles of chemotherapy was first increased and then decreased,and reached the peak in the fourth cycle,but the level of depression in the last chemotherapy cycle was still higher than that before the first chemotherapy;four potential categories were identified by GMM analysis,which were low depression group(54.0%),depression rising group(6.6%),depression elasticity group(10.1%)and depression declining group(29.3%)2.Analysis of influence factors of major chemotherapy-related symptoms in breast cancer patients(1)Influencing factors of potential categories of fatigue trajectory in breast cancer chemotherapy patientsThe analysis of breast cancer patients with four cycles of chemotherapy showed that the patients with education level of primary school or junior high school,low family income and chemotherapy regimen containing anthracycline drugs had a higher degree of fatigue in the whole chemotherapy cycle;the analysis of breast cancer patients with eight cycles of chemotherapy showed that the patients with younger age and perimenopause had a higher degree of fatigue in the whole chemotherapy cycle.(2)Influencing factors of potential categories of pain trajectory in breast cancer chemotherapy patientsThe analysis of breast cancer patients with four cycles of chemotherapy showed that the patients with younger age,living alone and chemotherapy regimen paclitaxel chemotherapy regimen had higher degree of pain in the whole chemotherapy cycle;the analysis of breast cancer patients with eight cycles of chemotherapy showed that the patients with per capita monthly income of 3001-6000 yuan and receiving extended mastectomy had higher degree of pain in the whole chemotherapy cycle.(3)Influencing factors of potential categories of anxiety trajectory in breast cancer chemotherapy patientsThe analysis of breast cancer patients with four cycles of chemotherapy showed that the patients with younger age,menstrual status of premenopausal,monthly menstrual regularity and disease stage II had higher anxiety level in the whole chemotherapy cycle;the analysis of breast cancer patients with eight cycles of chemotherapy showed that the patients who lived alone and had junior high school and senior high school education had higher anxiety level in the whole chemotherapy cycle.(4)Influencing factors of potential categories of depression trajectory in breast cancer chemotherapy patientsThe analysis of breast cancer patients with four cycles of chemotherapy showed that younger and living alone patients had a higher degree of depression in the whole chemotherapy cycle;the analysis of breast cancer patients with eight cycles of chemotherapy showed that younger and self-employed patients had a higher degree of depression in the whole chemotherapy cycle.[Conclusion]1.The overall trends of the main chemotherapy-related symptoms of breast cancer patients are different.The upward trend is the fatigue of patients with four cycles of chemotherapy,the fatigue of patients with eight cycles of chemotherapy,the fatigue of patients with a single chemotherapy cycle,the anxiety of patients with eight cycles of chemotherapy,and the The depression of patients with four cycle chemotherapy and the depression of patients with eight cycles of chemotherapy;the pain of patients with four cycles of chemotherapy,the pain of patients with eight cycles of chemotherapy,and the anxiety of patients with four cycles of chemotherapy showed a downward trend.2.The potential categories of the main chemotherapy-related symptoms of breast cancer patients are different.The anxiety of four-cycle chemotherapy patients and the anxiety of eight-cycle chemotherapy patients have two potential categories of symptom trajectories;The trajectory includes fatigue of four-cycle chemotherapy patients,fatigue of eight-cycle chemotherapy patients,fatigue of a single chemotherapy cycle,pain of fourcycle chemotherapy patients,pain of eight-cycle chemotherapy patients,and anxiety of eight-cycle chemotherapy patients have three potential categories of symptom trajectories;Four potential categories of symptom change trajectories were identified,including depression in patients with four cycles of chemotherapy and depression in patients with eight cycles of chemotherapy.3.When performing fatigue management on breast cancer patients undergoing fourcycle chemotherapy,pay close attention to patients with low education,low family income and using anthracycline chemotherapy;when performing fatigue management on breast cancer patients receiving eight-cycle chemotherapy,pay close attention to age Smaller,perimenopausal patients.4.Pain management for breast cancer patients undergoing four cycles of chemotherapy should pay close attention to patients who are younger,living alone,and paclitaxel-based chemotherapy regimens;when performing pain management for breast cancer patients undergoing eight cycles of chemotherapy,pay close attention to the family monthly average Patients whose income is between 3001-6000 yuan and undergoing mastectomy.5.When carrying out anxiety management for breast cancer patients undergoing four cycles of chemotherapy,it is necessary to pay close attention to patients who are younger,have a menstrual condition that is not menopausal,have regular monthly menstruation,and whose disease is stage Ⅱ;and carry out anxiety management for breast cancer patients who receive eight cycles of chemotherapy.At this time,high attention should be paid to patients living alone.6.When carrying out depression management for breast cancer patients undergoing four cycles of chemotherapy,it is necessary to pay close attention to younger and living alone patients;when carrying out depression management for breast cancer patients undergoing eight cycles of chemotherapy,it is necessary to pay great attention to younger age and self-employed occupations.patient. |
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