早期肺癌患者术后核心症状的识别及其影响因素与护理对策 [中文引用][英文引用]

目的  调查早期肺癌患者术后症状体验，识别其症状网络与核心症状，为实施个性化护理干预提供依据。方法  采用便利抽样法，选取 2024 年 1 月— 7 月在本市某三级甲等综合医院行手术治疗的 422 例早期肺癌患者作为研究对象，应用肺癌患者术后症状量表、疾病感知问卷简表和恐动症评估简表进行调查，采用多重线性回归分析早期肺癌患者术后核心症状的影响因素。结果  422 例患者完成研究。早期肺癌患者术后疼痛发生率最高（81.5%），疲劳为最核心症状（中心度rs=1.74）。年龄 <60 岁、女性、高疾病感知水平、淋巴结清扫和恐动症者术后症状评分较高（均 P<0.05）。在症状网络中，疲劳在强度中心度、紧密中心度和中介中心度均占据首位。结论  早期肺癌患者术后疼痛发生率较高，疲劳是症状网络最核心的症状；早期肺癌患者术后症状的影响因素较多，护理人员应采用针对性的策略，特别应关注其疼痛和疲劳体验，早期减轻患者的症状负担。

Objective To explore the postoperative symptoms experienced by the patients after surgery for early lung cancer and develop a symptom network for identification of the core symptoms，so as to provide a basis for individualised postoperative interventions. Methods A convenience sampling method was used to recruit 422 patients who received thoracoscopic surgery for early lung cancer in our hospital between January and July 2024. The frequency and severity of the symptoms during hospitalisation were assessed using the postoperative symptom scale，the brief illness perception questionnaire，and the kinesiophobia scale. The key factors that influenced symptoms were analysed using generalised linear regression. Results A total of 422 patients completed the study. Among the postoperative symptoms in the patients after surgery for early lung cancer，the postoperative pain was the highest incidence，with a rate of 81.5%. Fatigue was identified as the core symptom，with a centrality score of 1.74. Patients <60 years of age，high disease perception level，female，lymph node dissection and the presence of kinesiophobia demonstrated higher score（P<0.05）. In the symptom network， fatigue ranked the highest in the intensity centrality，closeness centrality and intermediate centrality. Conclusion Patients who received surgery for early lung cancer have a high incidence of postoperative pain. Within the symptom network，fatigue is the core symptom. There are many factors that affect postoperative symptoms in early lung cancer patients，and nurses can adopt targeted strategies，especially focusing on their pain and fatigue experiences，to alleviate the patient’s symptom burden in the early stage.