Verification of Chinese version of anorexia/cachexia subscale-12 in patients who undergo lung cancer radiotherapy
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摘要:
目的 肺癌患者在放疗期间常常出现厌食、营养不良,目前尚缺乏专门评估厌食的工具。本研究对中文版厌食/恶液质量表-12(anorexia/cachexia subscale-12, A/CS-12)进行验证,探讨其在肺癌放疗患者中的临床应用价值。 方法 2018年1—6月,采用方便抽样法对浙江省肿瘤医院胸部肿瘤放疗科的128例肺癌患者在放疗期间进行量表调查,同时收集患者近3 d的24 h膳食记录,并计算其日实际平均热量摄入,以评价其信效度。 结果 通过探索性因子分析可提取5个特征根植>1的公因子,各条目的内容效度为0.800~1.000,总量表的内容效度为0.950,量表得分与患者日平均进食量比较得出24分为对应的最佳界值,可信区间为0.644~0.951。各因子相互之间的相关系数在-0.145~0.399(均P < 0.001),其中3个因子与总量表的相关系数为0.670~0.764(P < 0.001),总量表的Cronbach's α系数为0.739,重测相关系数为0.980。 结论 中文版A/CS-12有良好的信度、效度,对肺癌患者在放疗期间进食减少具有一定诊断作用,可作为中国肺癌患者在放疗期间的厌食评估工具。 Abstract:Objective Patients with lung cancer often suffer from anorexia and malnutrition during radiotherapy. However, tools to specifically evaluate anorexia in these patients are currently lacking. The Chinese version of anorexia/cachexia subscale-12 (A/CS-12) was validated and its clinical application value in patients who undergo lung cancer radiotherapy was explored in this study. Methods From January 2018 to June 2018, 128 patients with lung cancer who were admitted in the Department of Chest Tumour Radiotherapy of Zhejiang Cancer Hospital and underwent radiotherapy were surveyed via a convenient sampling method. The patients' 24-hour diet records for the past 3 days were collected, and their daily average calorie intake was calculated to evaluate their reliability and validity. Results Exploratory factor analysis revealed that five common factors with feature roots greater than 1 could be extracted, and the content validity of each item ranged from 0.800 to 1.000. The content validity of the total scale was 0.950. The score of the scale was compared with the patient's average daily food intake (not a table but a graph), which provided 24 points corresponding to the best cut-off value. The confidence interval ranged from 0.644 to 0.951. The correlation coefficients of various factors were between -0.145 and 0.399 (P < 0.001), and the correlation coefficients between 3 factors and the total table are 0.670-0.764 (P < 0.001). Cronbach's α coefficient of the total table was 0.739, and the retest correlation coefficient was 0.980. Conclusion The Chinese version of A/CS-12 not only has a good reliability and validity but also has a diagnostic effect on the reduction in the food intake of lung cancer patients during radiotherapy. It can be used as evaluation tool for anorexia among Chinese patients undergoing lung cancer radiotherapy. -
Key words:
- Lung cancer /
- Cachexia /
- Radiotherapy /
- Reliability /
- Validity
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表 1 A/CS-12(分)
项目 无 有一点 有些 相当 非常 食欲佳 0 1 2 3 4 摄食量足够 0 1 2 3 4 担心体重超标 0 1 2 3 4 多数食物对我来说口味不快 4 3 2 1 0 担心自己消瘦 4 3 2 1 0 进食时对食物缺乏兴趣 4 3 2 1 0 难以进食丰富或大量食物 4 3 2 1 0 家人朋友督促进食 4 3 2 1 0 呕吐 4 3 2 1 0 早饱 4 3 2 1 0 胃部疼痛 4 3 2 1 0 体质好转当中 0 1 2 3 4 表 2 中文版A/CS-12量表条目重要性的专家咨询结果
条目 内容效度(I-CVI) 条目 内容效度(I-CVI) 条目1 1.000 条目7 1.000 条目2 1.000 条目8 1.000 条目3 1.000 条目9 1.000 条目4 1.000 条目10 0.800 条目5 1.000 条目11 0.800 条目6 1.000 条目12 0.800 注:量表内容效度(S-CVI)为0.950。 表 3 量表各条目的因子载荷度
条目 因子1 因子2 因子3 因子4 因子5 条目4 0.900 条目7 0.845 条目6 0.689 条目3 0.653 条目9 0.871 条目10 0.854 条目8 0.787 条目1 0.901 条目2 0.812 条目5 0.613 条目12 0.894 条目11 0.870 表 4 各因子之间及与量表总分的相关性(r值)
项目 总量表 因子1 因子2 因子3 因子4 因子1 0.764a 因子2 0.670a 0.280 因子3 0.719a 0.399 0.211 因子4 0.429 0.368 0.174 0.115 因子5 0.281 0.091 0.211 0.175 -0.145 注:aP < 0.001。 -
[1] 吴丹, 雷李培, 张杰, 等. 连续胸椎旁神经阻滞复合全身麻醉对肺癌患者术后康复和免疫功能的影响[J]. 中华全科医学, 2019, 17(6): 1033-1036, 1041. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201906040.htm [2] 张国林. 糖尿病及二甲双胍对肺癌放疗预后的影响[J]. 糖尿病新世界, 2018, 21(7): 194-196. https://www.cnki.com.cn/Article/CJFDTOTAL-TNBX201807099.htm [3] 钟时汝, 马玲国, 王木清, 等. Orem自理模式对晚期声门癌患者癌因性疲乏的影响[J]. 海南医学, 2016, 27(19): 3263-3265. doi: 10.3969/j.issn.1003-6350.2016.19.062 [4] 张书勤, 马薇, 魏柏. 不同剂量泼尼松方案对晚期胃肠道肿瘤患者癌性疲劳、厌食及营养状态的影响[J]. 海南医学, 2017, 28(17): 2786-2789. doi: 10.3969/j.issn.1003-6350.2017.17.011 [5] LAVIANO A, KOVERECH A, SEELAENDER M. Assessing pathophysiology of cancer anorexia[J]. Curr Opin Clin Nutr Metab Care, 2017, 20(5): 340-345. doi: 10.1097/MCO.0000000000000394 [6] 马怀幸, 李苏宜. 肿瘤厌食发生机制及其诊治[J]. 肿瘤代谢与营养电子杂志, 2018, 5(2): 117-121. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLDX201802002.htm [7] TARRICONE R, RICCA G, NYANZI-WAKHOLI B, et al. Impact of cancer anorexia-cachexia syndrome on health-related quality of life and resource utilisation: A systematic review[J]. Crit Rev Oncol Hematol, 2016, 99: 49-62. doi: 10.1016/j.critrevonc.2015.12.008 [8] 姜宁, 邵征洋, 詹璐. 中药健脾贴敷联合推拿治疗脾胃虚弱型小儿厌食症的疗效观察[J]. 中华全科医学, 2019, 17(3): 471-474. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201903037.htm [9] 杜红珍, 魏雨佳, 张玲玲, 等. 肿瘤患者食欲的评价及药物干预[J]. 肿瘤代谢与营养电子杂志, 2017, 4(1): 120-124. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLDX201701035.htm [10] 杨红, 陆宇晗, 康洁, 等. 中文版优逝量表在肿瘤科护士中应用的信效度评价[J]. 中国实用护理杂志, 2018, 34(19): 1451-1456. doi: 10.3760/cma.j.issn.1672-7088.2018.19.003 [11] 中华医学会肠外肠内营养学分会. 肿瘤患者营养支持指南[J]. 中华外科杂志, 2017, 55(11): 801-829. doi: 10.3760/cma.j.issn.0529-5815.2017.11.001 [12] 崔岩岩, 贾玫. 癌性厌食的治疗[J]. 中国临床医生杂志, 2017, 45(4): 6-8. doi: 10.3969/j.issn.2095-8552.2017.04.003 [13] BLAUWHOFF-BUSKERMOLEN S, RUIJGROK C, OSTELO R W, et al. The assessment of anorexia in patients with cancer: Cut-off values for the FAACT-A/CS and the VAS for appetite[J]. Support Care Cancer, 2016, 24(2): 661-666. doi: 10.1007/s00520-015-2826-2 [14] SPEXOTO M C, SERRANO S V, HALLIDAY V, et al. Cancer appetite and symptom questionnaire (CASQ) for Brazilian patients: Cross cultural adaptation and validation study[J]. PLoS One, 2016, 11(6): e0156288. doi: 10.1371/journal.pone.0156288 [15] National Comprehensive Cancer Network. NCCN Clinical Practice Guideline in Oncology palliative care, 2017[EB/OL]. [2019-06-15]. https://www.nccn.org/store/login/login.aspx?ReturnURL=https//www.nccn.org/professionals/physician_gls/pdf/palliative.pdf. [16] Oncology Nursing Society. Putting evidence into practice anorexia, 2017[EB/OL]. [2019-06-15]. https://www.ons.org/pep/anorexia. [17] 中国抗癌协会肿瘤护理专业委员会. 《中国癌症症状管理实践指南》-厌食[J]. 护理研究, 2019, 33(15): 2549-2556. doi: 10.12102/j.issn.1009-6493.2019.15.001 [18] ZHOU T, FANG K, THAPA S, et al. Validation of the Chinese version of functional assessment of anorexia-cachexia therapy(FAACT) scale for measuring quality of life in cancer patients with cachexia[J]. Support Care Cancer, 2017, 25(4): 1183-1189. doi: 10.1007/s00520-016-3508-4 [19] 李涛, 吕家华, 郎锦义, 等. 恶性肿瘤放射治疗患者肠内营养专家共识[J]. 肿瘤代谢与营养电子杂志, 2017, 4(3): 272-279. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLDX201703006.htm [20] 孙宇楠, 段琼玉, 牛楠, 等. 立体定向体部放疗联合或不联合化疗治疗≥5 cm的非小细胞肺癌的临床疗效及不良反应[J]. 现代肿瘤医学, 2018, 26(3): 360-363. doi: 10.3969/j.issn.1672-4992.2018.03.010