| Summary: | 博士 === 國立臺北護理健康大學 === 護理研究所 === 101 === Gastric cancer patients are often distressed by various postoperative gastrointestinal symptoms and by concern about food consumption and weight changes. The aim of this study was to investigate symptom distress and its predictors among patients with newly diagnosed gastric cancer within 6 months postoperatively. Study subjects of this longitudinal study were 58 patients over 20 years of age. Data were collected preoperatively, on the day of discharge, and 3 and 6 months postoperatively. The Dysfunction After Upper Gastrointestinal Surgery for Cancer (DAUGS32) Scoring System and an open question were used. Data were collected between Aug 31, 2011 and Jan 9, 2013. Quantitative data analysis by GEE model was performed using software package SPSS 20.0. Information from the open question was analyzed verbatim.
Study results revealed that symptom distress was greatest on the day of discharge and was significantly different from preoperative symptom distress. Symptom distress at 3 and 6 months postoperatively was not significantly different from preoperative symptom distress. Preoperative symptom distress and that on the day of discharge could not be used to predict symptom distress at subsequent time points. The average body mass index (BMI) was greatest preoperatively, trending downward from day of
discharge to 3 and 6 months postoperatively, and was significantly different from preoperative BMI. BMI values both preoperatively and on the day of discharge could predict subsequent BMI values. Unplanned revisit number totaled 24 during the first 3 months postoperatively, decreasing to 7 between 3 and 6 months postoperatively, showing a statistically significant difference. Analyses showed that predictors of symptom distress were education, scope of resection, daily meal frequency, intake per meal, perceived intake, awareness of food properties as categorized by Traditional Chinese Medicine, unplanned revisit number, and symptom management type. No robust predictors for BMI were noted. The analysis also showed that important predictors for unplanned revisit were living with relatives, disease phase, and symptom management type.
Symptom care program for gastric cancer patients after surgery and strategies to reduce unplanned revisits may need further investigation. More evidence-based studies are required to provide more suitable and individualized care.
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