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护理学报 ›› 2023, Vol. 30 ›› Issue (16): 1-6.doi: 10.16460/j.issn1008-9969.2023.16.001

• 研究生园地 •    下一篇

白血病儿童化疗多维症状体验的同期症状网络分析

方加1a, 许丽玲2, 刘春琴3, 刘霞3, 王妹香2, 刘琼1a, 黄海英1b, 肖新华1b, 林艳1a   

  1. 1.广州医科大学附属妇女儿童医疗中心,广东省儿童健康与疾病临床医学研究中心 a.护理部;b.血液肿瘤科,广东 广州 510623;
    2.广东药科大学 护理学院,广东 广州 510006;
    3.广州医科大学 护理学院,广东 广州 510182
  • 收稿日期:2023-03-22 出版日期:2023-08-25 发布日期:2023-09-08
  • 通讯作者: 林艳（1975-）,女,广东潮阳人,硕士,主任护师。E-mail: ly26937@126.com
  • 作者简介:方加（1995-）,男,湖北武汉人,本科学历,硕士研究生在读,护师。
  • 基金资助:
    国家自然科学基金青年科学基金项目（82100178）; 广州市卫生健康科技项目（项目编号202201020626）

Contemporaneous symptom networks in children with acute leukemia during chemotherapy: a network analysis

FANG Jia1a, XU Li-ling2, LIU Chun-qin3, LIU Xia3, WANG Mei-xiang2, LIU Qiong1a, HUANG Hai-ying1b, XIAO Xin-Hua1b, LIN Yan1a   

  1. 1a. Dept. of Nursing Administration; 1b.Dept. of Hematology & Oncology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China;
    2. School of Nursing, Guangdong Pharmaceutical University, Guangzhou 510006, China;
    3. School of Nursing, Guangzhou Medical University, Guangzhou 510182, China
  • Received:2023-03-22 Online:2023-08-25 Published:2023-09-08

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摘要： 目的 建立急性白血病患儿化疗多维症状体验的同期症状网络,探讨急性白血病儿童化疗期间的核心症状和症状间的相互关系。方法 采用便利抽样法,选取2021年1月—2022年10月在广州市1所三级甲等医院血液肿瘤科收治的374例急性白血病儿童作为研究对象,采用记忆症状量表儿童版进行问卷调查。运用R软件包构建了包括31种症状的同期症状网络,并使用网络分析的方法探索核心症状和分析症状间的关系。结果 在症状网络中,担忧或焦虑（rs=1.178,rc=0.001,rb=90.000）强度、紧密中心性值最大,烦躁易惹（rs=0.893,rc=0.001,rb=107.000）是中介中心性指数最高的症状。缺乏活力是急性白血病儿童化疗最普遍的症状,但其中心性指数低于其它症状。化疗期间诱导缓解期症状网络密度显著高于其它化疗周期（巩固加强期和维持治疗期）症状网络密度（χ2=14.771,P<0.001）。结论 症状网络为构建临床个性化的精准护理策略提供了新的经验性数据。研究表明需要评估症状网络的中心性指数和网络密度作为急性白血病儿童症状管理的重要组成部分,特别是处于诱导缓解期化疗的儿童。未来的研究有必要在纵向数据中建立动态症状网络和中心性指数的轨迹,以探索症状和干预标志物之间的因果关系。

关键词: 儿童, 急性白血病, 护理, 症状管理, 网络分析

Abstract: Objectives To establish a contemporaneous symptom network that captures the multidimensional symptom experience of children receiving chemotherapy for acute leukemia and to explore the core symptoms and relationship among symptoms. Methods A total of 374 cases of pediatric acute leukemia admitted to hematology-oncology department of a tertiary hospital's from January 2021 to October 2022 were selected as the study subjects using convenient sampling. The occurrence and severity of symptoms were investigated using the Children's Memory Symptom Scale. A contemporaneous symptom network including 31 symptoms was constructed using the R package. The core symptoms and the relationship among symptoms were explored using network analysis. Results The network showed worrying (rs=1.178, rc=0.001, rb=90.000) and feeling irritable (rs=0.893, rc=0.001, rb=107.000) were the most central symptoms across three centrality indices including strength, closeness, and betweenness. Lack of energy is the most common symptom in children undergoing chemotherapy for acute leukemia, but it has lower central indices than other symptoms. The density of the induction remission network differed significantly from that of the consolidation strengthening and maintenance network (χ2=14.771,P<0.001). Conclusion Symptom network provides new empirical data for the precise nursing strategy in clinical practice. There is a need to assess centrality indices and network density as critical components of pediatric cancer care, especially for children in induction remission. Future studies must establish trajectories of dynamic symptom networks and centrality indices in longitudinal data to explore the causal relationships between symptoms and intervention markers.

Key words: children, acute leukemia, nursing, symptom management, network analysis

中图分类号: 

  • R473.55
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