目的 了解鼻咽癌患者同步放化疗症状困扰、患者积极度现状，探讨两者关系，并分析症状困扰的影响因素。方法 2023年6-9月，采用一般资料调查表、M.D.Anderson症状调查量表-头部和颈部、患者积极度量表对广州市某三级甲等肿瘤专科的135例鼻咽癌同步放化疗患者进行调查与分析。 结果 患者症状困扰得分3.34±1.92，20%的NPC患者症状困扰处于中重度水平；发生频率较高的症状依次为胃口差 (95.6%) 、疲乏(93.4%) 、口干 (92.65%) 、恶心 (92.65%) ，严重程度较高的症状依次为味觉异常（5.50±3.14）、胃口差（5.16±2.67）、恶心（4.48±2.68）、口干（4.43±2.67）、便秘（4.29±2.77）、苦恼（4.25±2.82）。患者积极度标准化得分为89.49±10.01分。相关分析显示，症状严重程度及症状困扰与患者积极度均存在负相关关系（r=-0.206, P=0.017; r=-0.209, P=0.015）。是否远处转移、放疗次数、患者积极度是症状困扰的影响因素，共解释总变异水平的26.1%(P<0.05)。 结论 NPC患者同步放化疗期间症状困扰水平较高，症状困扰与患者积极度水平存在负相关关系，护理工作者应实施有效手段帮助患者应对症状困扰，调动患者参与疾病管理的积极性，增强患者自我管理的信心。

Objective To investigate symptom distress and patient activation in patients with nasopharyngeal carcinoma(NPC) undergoing chemoradiotherapy and to analyze the influencing factors of symptom distress. Methods From June to September 2023, a total of 135 patients who received concurrent chemoradiotherapy in a tertiary oncology department in Guangzhou were investigated and analyzed using M.D.Anderson Symptom Inventory (MDASD-Head and Neck), and Patient Activation Scale. Results The total scores of MDASI-HN of NPC patients were 3.34±1.92, and 20% patients with in moderate to severe level. The symptoms with highest frequency were poor appetite (95.6%), fatigue (93.4%), dry mouth (92.65%), and nausea (92.65%). The most severe symptoms were abnormal taste (5.50±3.14), poor appetite (5.16±2.67), nausea (4.48±2.68), dry mouth (4.43±2.67), constipation (4.29±2.77), and distress (4.25±2.82). The standardized score of patient activation was 89.49±10.01. Symptom severity and symptom distress were negatively correlated with patient activation (r=-0.206, P=0.017; r=-0.209, P=0.015). M, times of radiotherapy and patient activation were the influencing factors of symptom distress, explaining 26.1% of the total variation level (P＜0.05). Conclusions NPC patients have a high level of symptom distress during concurrent chemoradiotherapy, and there is a negative correlation between symptom distress and patient activation. Nursing workers should help patients to manage symptoms, mobilize patients' enthusiasm to participate in disease management, enhance patients' confidence in self-management, and help patients actively deal with existing symptoms and diseases.