Correlation of supportive care needs with symptom clusters and coping strategies in breast cancer patients undergoing neoadjuvant chemotherapy

doi:10.3877/cma.j.issn.1674-0807.2024.04.006

Abstract

Abstract:

Objective

To investigate the current status of supportive care needs in breast cancer patients undergoing neoadjuvant chemotherapy, as well as the correlations with patients’symptom clusters and coping strategies.

Methods

A cross-sectional study was conducted among 114 breast cancer patients who received neoadjuvant chemotherapy in the First People's Hospital of Lianyungang from November 2021 to October 2022, using convenience sampling.The Supportive Care Needs Survey-Short Form 34 (SCNS-SF34), the Memorial Symptom Assessment Scale (MSAS) and the Simplified Coping Style Questionnaire (SCSQ) were applied for the surveys of enrolled patients.Exploratory factor analysis was used to extract symptom clusters.The scores of SCNS-SF34, MSAS, and SCSQ between patients with different clinical characteristics were compared using t test or one-way analysis of variance.Pearson correlation analysis was used for the correlation between SCNS-SF34 (total score and scores for different dimensions) and coping strategies, MSAS and symptom clusters.Multiple linear regression was used to analyze the effects of clinical characteristics, MSAS and SCSQ scores on SCNS-SF34 scores.

Results

A total of 123 questionnaires were distributed, with 114 valid questionnaires collected (92.7%).The total scores of MSAS, SCSQ, and SCNS-SF34 in 114 patients were 100.27±25.60, 2.46±4.77 and 106.94±12.49, respectively.The main symptom clusters during neoadjuvant chemotherapy included gastrointestinal symptoms, psychological-sleep disorders, and cancer-related fatigue.Statistically significant differences were observed in MSAS, SCSQ, and SCNS-SF34 scores among patients with different residences, monthly household income and chronic medical history (MSAS: t=-3.025, P=0.003; F=14.885, P<0.001; t=-3.552, P<0.001; SCSQ: t=4.346, P<0.001; F=47.481, P<0.001; t=5.322, P<0.001; SCNS-SF34: t=-2.907, P=0.004; F=16.505, P<0.001; t=-4.684, P<0.001).The SCSQ and SCNS-SF34 scores also showed a significant difference between patients with different ages and education backgrounds (SCSQ: F=20.908, P<0.001; F=10.200, P<0.001; SCNS-SF34: F=4.614, P=0.012; F=3.363, P=0.038). The patients with different chemotherapy cycles showed a significant difference in MSAS and SCNS-SF34 scores (F=14.050, P<0.001; F=3.792, P=0.026).Except for sexual demand, the total score of MSAS and the scores of each symptom cluster were positively correlated with the total score of SCNS-SF34 and the scores of other dimensions (all P<0.050), and the SCSQ score was negatively correlated with the total score of SCNS-SF34 and the scores of other dimensions (all P<0.050). Worries and coping strategies were influencing factors of SCNS-SF34 scores in breast cancer patients undergoing neoadjuvant chemotherapy(B=1.573, 95%CI: 0.587 to 2.559, P=0.002; B=-0.857, 95%CI: -1.523 to -0.192, P=0.012).

Conclusions

Breast cancer patients undergoing neoadjuvant chemotherapy have many unmet supportive care needs.Patients with positive coping strategies tend to have less supportive care needs.The main symptoms during chemotherapy are gastrointestinal symptoms, psychological-sleep symptoms and fatigue, all of which can increase patients’supportive care needs.

Key words: Breast neoplasms, Neoadjuvant chemotherapy, Supportive care needs, Coping strategies

Huan Yang, Liang Ma, Jun Shen, Lili Dong, Wenwen Sun. Correlation of supportive care needs with symptom clusters and coping strategies in breast cancer patients undergoing neoadjuvant chemotherapy[J]. Chinese Journal of Breast Disease(Electronic Edition), 2024, 18(04): 224-230.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhrxbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0807.2024.04.006

https://zhrxbzz.cma-cmc.com.cn/EN/Y2024/V18/I04/224

Figures/Tables 6

References 26

[1]	汪凯林，李舜颖，刘强．第5版《年轻女性乳腺癌国际共识指南》更新要点解读[J/CD].中华乳腺病杂志(电子版)，2023，17(2)：65-71.
[2]	Sung H, Ferlay J, Siegel RL, et al.Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin, 2021，71(3)：209-249.
[3]	王海，陈盛，李俊杰，等．乳腺癌新辅助化疗的共识与争议[J].中华肿瘤杂志，2021，43(4)：504-509.
[4]	栗晓坤，刘瑞云，霍静，等．乳腺癌病人症状群与生活质量的相关性分析[J].护理研究，2021，35(12)：2248-2250.
[5]	Faller H, Hass HG, Engehausen D, et al.Supportive care needs and quality of life in patients with breast and gynecological cancer attending inpatient rehabilitation.A prospective study[J].Acta Oncol, 2019，58(4)：417-424.
[6]	van der Kruk SR, Butow P, Mesters I, et al.Psychosocial well-being and supportive care needs of cancer patients and survivors living in rural or regional areas: a systematic review from 2010 to 2021[J].Support Care Cancer, 2022，30(2)：1021-1064.
[7]	徐芸，张海燕，蒋春燕，等．乳腺癌术后化疗患者支持性照顾需求、心理弹性及生活质量的相关性[J/CD].中华乳腺病杂志(电子版)，2021, 15(6)：352-358.
[8]	Okati-Aliabad H, Ansari-Moghadam A, Mohammadi M, et al.The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer[J].Support Care Cancer，2022，30(1)：703-710.
[9]	祝龙玲，蒋晓莲，彭维雪，等．乳腺癌术后化疗患者症状群的纵向研究[J].护理学杂志，2022，37(20)：23-27.
[10]	解亚宁．简易应对方式量表信度和效度的初步研究[J].中国临床心理学杂志，1998，6(2)：53-54.
[11]	Boyes A, Girgis A, Lecathelinais C．Brief assessment of adult cancer patients'perceived needs: development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34)[J].J Eval Clin Pract, 2009，15(4)：602-606.
[12]	马祥敏，张香梅，周新平，等．HP联合新辅助化疗治疗HER2阳性乳腺癌患者腋窝病理完全缓解影响因素[J].中华肿瘤防治杂志，2022，29(24)：1761-1767.
[13]	Cai YJ, Masaki H, Shi TY.Supportive care needs of chinese women with newly diagnosed breast cancer prior to adjuvant chemotherapy[J].Oncol Nurs Forum, 2021，48(3)：341-349.
[14]	尚子妺，吴静，周洁，等．乳腺癌患者睡眠及相关症状的轨迹研究[J].中华护理杂志，2019，54(10)：1456-1462.
[15]	Lo-Fo-Wong DNN, de Haes HCJM, Aaronson NK, et al.Risk factors of unmet needs among women with breast cancer in the post-treatment phase[J].Psychooncology, 2020，29(3)：539-549.
[16]	张惠婷，罗庆华，刘琳妃，等．乳腺癌患者术后患肢功能状况的纵向研究[J].现代临床护理，2020，19(1)：52-58.
[17]	孙修侠，彭永强，王晓东等．基于希望理论的护理干预对乳腺癌术后化疗患者症状困扰与生活质量的影响[J].中国医药导报，2022，19(21)：181-184.
[18]	Akechi T, Okuyama T, Endo C, et al.Patient's perceived need and psychological distress and/or quality of life in ambulatory breast cancer patients in Japan[J].Psychooncology, 2011，20(5)：497-505.
[19]	喻莹，万永慧，唐尧，等．应对方式在乳腺癌术后化疗患者需求与主观幸福感中的中介效应[J].中国医药导报，2022，19(21)：53-56，69.
[20]	Au A, Lam W, Tsang J, et al.Supportive care needs in Hong Kong Chinese women confronting advanced breast cancer.Psychooncology[J], 2013，22(5)：1144-1151.
[21]	Erdoǧan Yüce G, Döner A, Muz G．Psychological distress and its association with unmet needs and symptom burden in outpatient cancer patients: a cross-sectional study[J].Semin Oncol Nurs, 2021，37(5)：151214.
[22]	Chan RJ, Teleni L, McDonald S, et al.Breast cancer nursing interventions and clinical effectiveness: a systematic review[J].BMJ Support Palliat Care，2020，10(3)：276-286.
[23]	李文静，康凤英，田伟，等．正念癌症康复训练对乳腺癌化疗期病人心身症状的影响[J].护理研究，2020，34(11)：2045-2049.
[24]	卢静，张朝晖．耳针治疗乳腺癌术后相关症状的临床研究现状和展望[J].中国针灸，2018，38(11)：1249-1254.
[25]	Dyson GJ, Thompson K, Palmer S, et al.The relationship between unmet needs and distress amongst young people with cancer[J].Support Care Cancer, 2012，20(1)：75-85.
[26]	Pereira-Morales AJ, Adan A, Lopez-Leon S，et al.Personality traits and health-related quality of life: the mediator role of coping strategies and psychological distress[J].Ann Gen Psychiatry，2018，17：25.

量表及维度	条目数	评分
MSAS^a	32	100.27±25.60
胃肠道症状群	3	24.08±6.10
心理－睡眠障碍症状群	3	20.75±5.94
癌因性疲乏症状群	3	19.42±6.23
SCSQ	20	2.46±4.77
积极	12	10.88±3.84
消极	8	－8.41±3.04
SCNS-SF34	34	106.94±12.49
生理与日常生活需求	5	16.56±3.16
心理需求	10	35.82±5.13
性需求	3	3.32±1.21
照顾与支持需求	5	14.56±2.88
健康信息需求	11	36.68±4.57

量表及维度	条目数	评分
MSAS^a	32	100.27±25.60
胃肠道症状群	3	24.08±6.10
心理－睡眠障碍症状群	3	20.75±5.94
癌因性疲乏症状群	3	19.42±6.23
SCSQ	20	2.46±4.77
积极	12	10.88±3.84
消极	8	－8.41±3.04
SCNS-SF34	34	106.94±12.49
生理与日常生活需求	5	16.56±3.16
心理需求	10	35.82±5.13
性需求	3	3.32±1.21
照顾与支持需求	5	14.56±2.88
健康信息需求	11	36.68±4.57

症状	症状群1	症状群2	症状群3
睡眠障碍	0.06	0.68	0.31
感到忧伤	0.40	0.64	0.22
精力不足	0.54	0.29	0.71
食欲不振	0.71	0.33	－0.11
眩晕	－0.16	0.51	0.86
呕吐	0.61	0.23	0.11
脱发	0.32	0.76	0.10
恶心/作呕	0.81	－0.21	0.18
感到昏昏欲睡	0.50	－0.09	0.61
手/脚麻痹或刺痛	－0.07	0.40	0.20

症状	症状群1	症状群2	症状群3
睡眠障碍	0.06	0.68	0.31
感到忧伤	0.40	0.64	0.22
精力不足	0.54	0.29	0.71
食欲不振	0.71	0.33	－0.11
眩晕	－0.16	0.51	0.86
呕吐	0.61	0.23	0.11
脱发	0.32	0.76	0.10
恶心/作呕	0.81	－0.21	0.18
感到昏昏欲睡	0.50	－0.09	0.61
手/脚麻痹或刺痛	－0.07	0.40	0.20

临床特征	例数	记忆症状评分			应对方式评分			支持性照顾需求评分
临床特征	例数	MSAS	检验值	P值	SCSQ	检验值	P值	SCNS-SF34	检验值	P值
年龄
18～44岁	21	91.52±26.92	F＝2.789	0.066	6.62±4.20^a	F＝20.908	<0.001	102.76±14.43^a	F＝4.614	0.012
45～59岁	62	99.34±25.89			2.71±4.51^a			105.68±12.21^a
≥60岁	31	108.06±22.46			－0.84±3.02			112.29±10.01
居住地
城市	61	93.84±27.11	t＝－3.025	0.003	4.15±4.54	t＝4.346	<0.001	103.87±13.08	t＝－2.907	0.004
农村或郊区	53	107.68±21.71	t＝－3.025	0.003	0.53±4.31	t＝4.346	<0.001	110.47±10.86	t＝－2.907	0.004
文化程度
高中及以上	25	95.52±25.19	F＝1.371	0.258	4.56±5.00^b	F＝10.200	<0.001	103.92±13.40^b	F＝3.363	0.038
初中	47	98.34±30.65			3.49±4.82^b			105.11±13.37^b
小学及以下	42	105.26±18.35			0.07±3.01			110.79±9.98
婚姻状况
已婚	109	100.30±26.08	t＝0.060	0.952	2.48±4.84	t＝0.126	0.900	106.98±12.66	t＝0.171	0.864
离异/丧偶	5	99.60±11.72	t＝0.060	0.952	2.20±3.11	t＝0.126	0.900	106.00±8.80	t＝0.171	0.864
家庭收入
>5000元	29	87.17±28.37^c	F＝14.885	<0.001	6.48±4.52^c	F＝47.481	<0.001	99.03±15.51^c	F＝16.505	<0.001
30001～4999元	59	97.92±20.75^c			2.80±3.54^c			106.75±9.60^c
≤3000元	26	120.23±20.86			－2.77±1.90			116.19±7.78
慢性病既往史
无	79	94.87±25.38	t＝－3.552	<0.001	3.89±4.61	t＝5.322	<0.001	103.92±12.64	t＝－4.684	<0.001
有	35	112.46±21.91	t＝－3.552	<0.001	－0.74±3.42	t＝5.322	<0.001	113.74±9.11	t＝－4.684	<0.001
病理分期
Ⅰ～Ⅱ期	74	100.05±25.85	t＝－0.123	0.902	2.82±4.98	t＝1.094	0.276	106.18±12.49	t＝－0.886	0.377
≥Ⅲ期	40	100.68±25.45	t＝－0.123	0.902	1.80±4.34	t＝1.094	0.276	108.35±12.52	t＝－0.886	0.377
化疗周期
1～2个	42	85.55±23.37	F＝14.050	<0.001	3.05±5.08	F＝1.123	0.329	103.07±10.57	F＝3.792	0.026
3～4个	46	106.78±24.21^d			1.65±4.40			108.17±11.54^d
≥5个	26	112.54±20.31d			2.96±4.86			111.00±15.41^d

Please choose a citation manager

Content to export