晚期心衰患者的症状体验及症状群研究

摘要

Objectives To investigate the symptom clusters in patients with advanced heart failure (HF)and build the foundation for the patients symptom management.Methods A total of 290 patients with advanced HF were interviewed.The symptom profile was assessed by Edmonton Symptom Assessment Scale (ESAS).Exploratory factor analysis was used to identify the symptom clusters.Results The patients' average age was (76.5 ± 7.2) years.Three distinct symptom clusters,decondition cluster (fatigue,shortness of breath drowsiness,and reduced appetite),distress cluster (anxiety and depression),and discomfort cluster (pain,nausea,and sense of generalized discomfort),were identified.These three symptom clusters accounted for 67.80％ of variances of the patients' symptom experience.The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another.Conclusions This study identified the unique symptom dusters in patients with advanced HE The results shed light on the need in developing palliative care interventions for optimizing the symptom control for this life-limiting disease.%目的 调查晚期心衰患者的症状经历探索其存在的症状群以期为晚期心衰患者的症状管理奠定基础.方法 对威海市三所三级甲等医院心内科收住的晚期心衰患者运用中文版的埃特蒙顿市症状量进行横断面调查,用探索性因子分析探索心衰患者存在的症状群.结果 晚期心衰患者的平均年龄为(76.5±7.2)岁,存在疲倦症状群(疲倦、气短、困倦、食欲不振),精神症状群(焦虑、抑郁),不适症状群(不舒适、疼痛、恶心),三个症状群共贡献67.80％的变异量.三个症状群间的相关性很小,Pearson’s相关系数为0.212 ～ 0.323.结论 晚期心衰患者存在独立的症状群,因此应积极开展姑息护理优化晚期心衰患者的症状管理,改善临终患者的生命质量.