Distinct Shortness of Breath Profiles in Oncology Outpatients Undergoing Chemotherapy.
Distinct Shortness of Breath Profiles in Oncology Outpatients Undergoing Chemotherapy.
复制标题
接受化疗的肿瘤科门诊患者出现明显的呼吸急促症状。
DOI：
10.1016/j.jpainsymman.2022.11.010
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发表时间：
2023
影响因子：
4.7
通讯作者：
Miaskowski,Christine
中科院分区：
文献类型：
--
作者：
Shin,Joosun;Kober,KordM;Wong,MelisaL;Yates,Patsy;Cooper,BruceA;Paul,StevenM;Hammer,Marilyn;Conley,Yvette;Levine,JonD;Miaskowski,Christine
背景呼吸急促是一种令人痛苦的症状，10%到70%的肿瘤患者会出现这种症状。尽管呼吸短促的发生范围很广，但对接受化疗的患者中呼吸短促的个体差异及其相关危险因素知之甚少。目的识别具有明显呼吸短促特征的患者亚组；评估这些亚组在人口学和临床特征上的差异；评估呼吸短促症状维度的差异，并评估生活质量结果的差异。方法门诊患者(n=1338)在两个化疗周期内完成了6次问卷调查。呼吸短促的发生采用记忆症状评定量表进行评估。结果发现有4种明显的呼吸短促现象(无[70.5%]，减少[8.2%]，增加[7.8%]，高[13.5%])。成为高级会员的危险因素包括：吸烟史，自我报告的肺部疾病诊断，患有肺癌，以及接受较高数量的癌症治疗。结论接受化疗的异质性癌症患者中，近14%的患者在近两个月的时间里呼吸急促的发生率持续较高。此外，与减少和增加的班级相比，高班级的呼吸短促发作更频繁、更严重。临床医生需要评估所有肿瘤患者的呼吸短促，并提供有针对性的干预措施。
ContextShortness of breath is a distressing symptom that occurs in 10% to 70% of oncology patients. Despite this broad range in its occurrence, little is known about inter-individual variability in shortness of breath and associated risk factors among patients receiving chemotherapy.ObjectivesIdentify subgroups of patients with distinct shortness of breath profiles; evaluate for differences among these subgroups in demographic and clinical characteristics; evaluate for differences among symptom dimensions of shortness of breath, and evaluate for differences in quality of life outcomes.MethodsOutpatients (n=1338) completed questionnaires six times over two chemotherapy cycles. Occurrence of shortness of breath was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath profiles.ResultsFour distinct shortness of breath profiles were identified (None [70.5%], Decreasing [8.2%], Increasing [7.8%], High [13.5%]). Risk factors for membership in High class included: history of smoking, self-reported diagnosis of lung disease, having lung cancer, and receipt of a higher number of cancer treatments. Compared to the None class, High class reported poorer physical, psychological, and social functioning.ConclusionsAlmost 14% of patients with heterogeneous types of cancer receiving chemotherapy had persistently high occurrence rates of shortness of breath for almost two months. In addition, compared to the Decreasing and Increasing classes, the High class’ episodes of shortness of breath were more frequent and more severe. Clinicians need to assess all oncology patients for shortness of breath and provide targeted interventions.