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目的 总结乳腺癌患者症状轨迹的现有证据,并识别与症状轨迹相关的预测因素.方法 采用Whit-temore和Knafl的整合综述方法,对PubMed、Embase、Web of Science和CINAHL数据库进行检索.检索文献发表时间限定为2010-2020年,仅纳入经过同行评审的英文文献.结果 经质量评价后最终纳入27篇论文.采用主题分析法对相关研究结果进行分析,归纳为2个主题:乳腺癌患者的症状轨迹(乳腺癌患者的症状轨迹、接受手术患者的症状轨迹、接受癌症相关治疗患者的症状轨迹)和相关因素(社会人口学因素、健康特征、癌症相关的治疗).新诊断为乳腺癌的患者倾向于报告高水平的抑郁及持续的睡眠障碍轨迹.大多数患者在接受手术后较短时间内报告有明显的睡眠障碍和焦虑症状轨迹.在接受癌症相关治疗的患者中,只有少数患者在治疗后能持续进行高水平的身体活动.体质指数高、家庭关系差、父母角色缺失、缺乏社会支持、教育程度低和不健康的生活方式可能会增加乳腺癌患者出现不良症状轨迹的风险.此外,接受化疗后,老年患者增加认知障碍的风险,而年轻患者容易出现持续的性功能受损轨迹.伴随症状和不良的健康状况也会导致不良症状轨迹.结论 本研究提供了乳腺癌患者症状轨迹更多的个体异质性信息.尽管乳腺癌患者在基线时症状相似,但随着时间的推移报告了不同的症状轨迹.护士应考虑社会人口学、临床和癌症相关治疗特征对乳腺癌患者症状轨迹的影响,并对患者实施有针对性的早期干预.“,”Objective:This study aimed to synthesize the available knowledge of symptom trajectories in patients with breast cancer and identify predictors associated with these trajectories.Methods:Whittemore and Knafl\'s integrative review method was employed to guide a systematic search for literature in four databases (PubMed,Embase,Web of Science,and CINAHL).The retrieved articles\' publication time was limited to 2010 to 2020,and only peer-reviewed English articles were included.Results:Twenty-seven articles were included.The findings of the relevant studies were analyzed using thematic analysis.They were grouped into two themes:symptom trajectories of patients with breast cancer (symptom trajectories in patients with breast cancer,in patients who underwent surgery,and in patients who received cancer-related treatment) and associated factors (socioeconomic factors,health characteristics,cancer-related treatment characteristics).Newly diagnosed patients tended to report high trajectories of depression and persistent sleep disturbance.Most patients who underwent surgery re-ported significant sleep disturbance and anxiety shortly after surgery.For patients who received cancer-related treatment,only a small proportion had a high level of physical activity after cancer-related therapy over time.A high body mass index,a low relationship quality,parental responsibilities,insuf-ficient social support,a low educational background,and an unhealthy lifestyle may increase the risk of negative symptom trajectories in patients with breast cancer.Additionally,old patients were more likely to report cognitive impairment after chemotherapy,while young patients tended to report trajectories of persistent sexual dysfunction.Concurring symptoms and poor health status also contributed to adverse symptom trajectories.Conclusion:The findings of this review add to the body of knowledge of the interindividual variability of symptom trajectories in patients with breast cancer.Despite the overall similarity in appraisal at base-line,the patients reported varied symptom trajectories over time.It is recommended that nurses consider sociodemographic,clinical and cancer-related treatment characteristics and perform targeted early preventive interventions for patients with breast cancer.