1
|
Lee T, Park J. Nonpharmacological Interventions for Managing Symptom Clusters in Adults: A Systematic Review. Biol Res Nurs 2024; 26:657-674. [PMID: 38899914 DOI: 10.1177/10998004241261258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Objectives: The complex effects of multiple co-occurring symptoms are a major cause of reduced quality of life; thus, it is necessary to identify symptom clusters experienced by patients and explore interventions. This study aimed to provide an overview of non-pharmacological interventions based on symptom clusters in adults to identify effective intervention strategies and methods. Methods. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. For the search databases, PubMed, Embase, Cochrane Library, CINAHL, RISS, KISS, and KISTI were used. It includes English and Korean experimental studies published up to May 2023. The literature quality was evaluated using the Joanna Briggs Institute Quality Assessment Tool. Results. Of the 18 studies selected, 15 were randomized controlled trials and three were quasi-experimental studies, all of which were conducted on patients with cancer. The symptom clusters-based interventions in the literature are classified as movement-based, relaxation-based, integrated, and miscellaneous interventions. Integrated interventions, which were effective in all studies, might prove to be very effective for managing symptom clusters. Movement-based intervention studies, which include dance, Qigong, and Tai Chi, might be very effective in improving health-related quality of life (HRQoL). Conclusions. This review demonstrates that non-pharmacological interventions reduce the occurrence and severity of symptom clusters, thereby improving HRQoL. Further studies are required to evaluate the effects of these interventions in patients with various chronic conditions other than cancer.
Collapse
Affiliation(s)
- Taekyeong Lee
- College of Nursing, Graduate School, Pusan National University, Yangsan, Republic of Korea
- Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jongmin Park
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| |
Collapse
|
2
|
Klafke N, Bossert J, Boltenhagen U, Froehlich D, Mahler C, Joos S, Wensing M. Counseling lifestyle medicine in oncology: A qualitative analysis of interprofessional patient-nurse-physician interactions. PATIENT EDUCATION AND COUNSELING 2024; 127:108352. [PMID: 38905751 DOI: 10.1016/j.pec.2024.108352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 05/23/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES Counseling plays a key role in promoting health behaviors, providing evidence-based information, and supporting patients with cancer during and after treatment. This study aimed to evaluate an interprofessional counseling service on Complementary and Integrative Health (CIH) for patients being treated at Comprehensive Cancer Centers (CCCs) in Southern Germany. METHODS Patients participating in the CCC-Integrativ study received three CIH counseling sessions within three months in addition to their conventional cancer treatment. Medical and nursing staff participated in a study-specific blended learning training program before conducting the counseling. As part of the process evaluation, 30 audio-recorded counseling sessions were transcribed verbatim and analyzed by conducting a content analysis using MAXQDA 2020. RESULTS Throughout the counseling, patients were conceded to address various health issues, which mainly revolved around symptom management interlaced with the areas of nutrition, exercise, and relaxation. The interprofessional teams conducted the counseling in a structured and patient-oriented manner. They worked together to motivate the patients to apply procedures from the CIH field independently, even if patients sometimes experienced difficulties in implementation. CONCLUSIONS Interprofessional collaboration improved healthcare quality, as patients received comprehensive and evidence-based advice on their supportive needs and lifestyle issues. Both professions could equally contribute their areas of knowledge and expertise and apply them to the benefit of the patients. PRACTICE IMPLICATIONS Providing an integrative counseling service and adequate training on interpersonal communication and CIH for healthcare professionals will improve patient-centered care.
Collapse
Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Boltenhagen
- Institute of Health Sciences, Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Daniela Froehlich
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Cornelia Mahler
- Institute of Health Sciences, Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
3
|
Lavoie Smith EM, Von Ah D. Neurotoxicity in Cancer Survivorship: The Significance of Cancer-Related Cognitive Impairment and Chemotherapy-Induced Peripheral Neuropathy. Semin Oncol Nurs 2024; 40:151724. [PMID: 39183088 DOI: 10.1016/j.soncn.2024.151724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 07/27/2024] [Accepted: 07/31/2024] [Indexed: 08/27/2024]
Affiliation(s)
- Ellen M Lavoie Smith
- Professor and Marie O'Koren Endowed Chair, Assistant Dean of Research and Scholarship, University of Alabama at Birmingham School of Nursing, Department of Acute, Chronic & Continuing Care, Birmingham, AL
| | - Diane Von Ah
- Mildred E. Newton Endowed Professor, Distinguished Professor of Cancer Research, The Ohio State University, College of Nursing, Columbus, OH.
| |
Collapse
|
4
|
Cai M, Gou J. Symptom clusters of patients with advanced thyroid cancer: a cross-sectional study. Endocrine 2024:10.1007/s12020-024-04051-4. [PMID: 39320592 DOI: 10.1007/s12020-024-04051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 09/16/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE To investigate and analyze the symptom clusters of patients with advanced thyroid cancer and provide a basis for developing targeted symptom management measures. METHODS Patients who visited a multidisciplinary outpatient service for advanced thyroid cancer at a tertiary A hospital in Sichuan Province from April 2022 to April 2023 were selected using convenience sampling. A cross-sectional survey was conducted using the M.D. Anderson Symptom Inventory-Thyroid Cancer module (MDASI-THY). Symptom clusters were extracted by exploratory factor analysis. RESULTS Disturbed sleep had the highest incidence (75.7%) and severity (3.0 points), while mood distress had the highest incidence (63.5%) and severity (2.0 points) of symptom interference. Three symptom clusters were identified: mood-fatigue-sleep, digestive tract-sensation, and thyroid cancer-specific symptom clusters. CONCLUSION Patients with advanced thyroid cancer have multiple symptom clusters that seriously affect their daily lives. Health care professionals should conduct targeted observation and preventive treatment to reduce the burden of symptoms on patients.
Collapse
Affiliation(s)
- Ming Cai
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Juxiang Gou
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
5
|
Campbell JK, Erickson JM. Interactive Health Literacy and Symptom Self-management in Patients With Lung Cancer: A Critical Realist Analysis. Cancer Nurs 2024; 47:397-407. [PMID: 37158678 DOI: 10.1097/ncc.0000000000001245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Patients with lung cancer experience multiple symptoms requiring self-management. Little is known about how self-management is influenced by interactive health literacy, defined as communicating with healthcare providers to obtain and process information. OBJECTIVE This study explored how interactive health literacy relates to symptom self-management among patients with lung cancer. A second aim explored how interactive health literacy might be integrated into the Individual and Family Self-management Theory. METHODS This study used a cross-sectional mixed-methods design. Quantitative data included demographics, the All Aspects of Health Literacy Scale, and the Memorial Symptom Assessment-Short Form. Qualitative data were collected using semistructured interviews. Data analysis followed a critical realist model. RESULTS Twelve adults who recently received treatment for lung cancer reported an average of 14 symptoms that caused moderate distress. Average interactive health literacy of the sample was in the moderate range. Participants' experiences of self-management differed based on their interactive health literacy. A generative mechanism proposes that those with higher interactive health literacy who accessed online information used this information as a basis for engaging with providers regarding potential symptom self-management strategies. CONCLUSIONS Interactive health literacy skills may play a role in patients' ability and confidence in symptom self-management through interactions with oncology providers. Further research should clarify the relationship between interactive health literacy, self-efficacy, and collaboration with oncology providers. IMPLICATIONS FOR PRACTICE The patient-provider relationship is a key factor influencing how patients obtain and process symptom self-management information. Oncology providers should implement patient-centered strategies to engage patients in symptom self-management.
Collapse
Affiliation(s)
- Julie K Campbell
- Authors Affiliations: School of Nursing, Lee University, Cleveland, Tennessee (Dr Campbell); and College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI (Dr Erickson)
| | | |
Collapse
|
6
|
Luo Y, Mao D, Zhang L, Zhu B, Yang Z, Miao J, Zhang L. Trajectories of depression and predictors in lung cancer patients undergoing chemotherapy: growth mixture model. BMC Psychiatry 2024; 24:578. [PMID: 39182063 PMCID: PMC11344456 DOI: 10.1186/s12888-024-06029-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Depression is prevalent among lung cancer patients undergoing chemotherapy, and the symptom cluster of fatigue-pain-insomnia may influence their depression. Identifying characteristics of patients with different depression trajectories can aid in developing more targeted interventions. This study aimed to identify the trajectories of depression and the fatigue-pain-insomnia symptom cluster, and to explore the predictive factors associated with the categories of depression trajectories. METHODS In this longitudinal study, 187 lung cancer patients who were undergoing chemotherapy were recruited and assessed at the first (T1), second(T2), and fourth(T3) months using the Patient Health Questionnaire-9 (PHQ-9), the Brief Pain Inventory (BPI), the Brief Fatigue Inventory (BFI), and the Athens Insomnia Scale (AIS). Growth Mixture Model (GMM) and Latent Class Analysis (LCA) were used to identify the different trajectories of the fatigue-pain-insomnia symptom cluster and depression. Binary logistic regression was utilized to analyze the predictive factors of different depressive trajectories. RESULTS GMM identified two depressive trajectories: a high decreasing depression trajectory (40.64%) and a low increasing depression trajectory (59.36%). LCA showed that 48.66% of patients were likely members of the high symptom cluster trajectory. Binary logistic regression analysis indicated that having a history of alcohol consumption, a higher symptom cluster burden, unemployed, and a lower monthly income predicted a high decreasing depression trajectory. CONCLUSIONS Depression and fatigue-pain-insomnia symptom cluster in lung cancer chemotherapy patients exhibited two distinct trajectories. When managing depression in these patients, it is recommended to strengthen symptom management and pay particular attention to individuals with a history of alcohol consumption, unemployed, and a lower monthly income.
Collapse
Affiliation(s)
- Yuanyuan Luo
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Dongmei Mao
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Le Zhang
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Benxiang Zhu
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou Avenue, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China.
| |
Collapse
|
7
|
Park JH, Chun M, Bae SH, Woo J, Chon E, Kim HJ. Latent profile analysis for assessing symptom clusters in women with breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01648-6. [PMID: 39066841 DOI: 10.1007/s11764-024-01648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE To identify symptom clusters among breast cancer survivors and investigate differences in health-related quality of life (HRQoL) and distress based on these discerned symptom clusters using latent profile analysis. METHODS We enrolled 655 adult breast cancer survivors aged 19 years and older, registered with the Cancer Survivor Integrated Supportive Center from May 2020 to July 2022. The study measured five symptoms-pain, fatigue, insomnia, anxiety, and depression-using a Visual Analogue Scale ranging from 0 to 10 points. Distress was measured using the National Comprehensive Cancer Network Distress Thermometer, with scores ranging from 0 to 10 points. HRQoL was determined using the EuroQol-5 Dimension questionnaire. Data analysis was conducted using the Jamovi and Mplus 8.8 software programs. RESULTS The Cluster with Few Symptoms (46.8%) was the most common, whereas the Psychological Cluster with a very high degree of depression and anxiety accounted for 20.0%, and the Moderate symptom cluster with symptoms of 3 or more points accounted for 14.4%. Distress scores were relatively high in the Psychological Cluster and the Pain-Fatigue-Insomnia Cluster, and were lowest in the Cluster with Few Symptoms (F = 103.92, p < 0.001). HRQoL scores were highest in the Cluster with Few Symptoms and lowest in the Pain-Fatigue-Insomnia Cluster (F = 177.62, p < 0.001). CONCLUSIONS Approximately half of breast cancer survivors who had completed the major treatment experienced persistent high symptoms such as depression and anxiety or pain, fatigue, and insomnia. IMPLICATIONS FOR CANCER SURVIVORS These findings provide foundational data for developing tailored intervention strategies and programs based on symptom experiences.
Collapse
Affiliation(s)
- Jin-Hee Park
- College of Nursing, Research institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Mison Chun
- Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Sun Hyoung Bae
- College of Nursing, Research institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Jeonghee Woo
- Cancer Center Management Team, Gyeonggi Regional Cancer Center, Suwon, Republic of Korea
| | - Eunae Chon
- Cancer Survivor Center, Gyeonggi Regional Cancer Center, Suwon, Republic of Korea
| | - Hee Jun Kim
- College of Nursing, Ajou University, 164, World cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
| |
Collapse
|
8
|
Chae S, Bae J, Youn N, Lopez KD, Sutamtewagul G, Rakel B. Agreement between patient-reported and clinically documented symptoms of acute myeloid leukemia: Study protocol. J Adv Nurs 2024. [PMID: 38969361 DOI: 10.1111/jan.16320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 06/19/2024] [Indexed: 07/07/2024]
Abstract
AIM To describe our methods to compare patient-reported symptoms of acute myeloid leukemia and the corresponding documentation by healthcare providers in the electronic health record. BACKGROUND Patients with acute myeloid leukemia experience many distressing symptoms, particularly related to chemotherapy. The timely recognition and provision of evidence-based interventions to manage these symptoms can improve outcomes. However, lack of standardized formatting for symptom documentation within electronic health records leads to challenges for clinicians when accessing and comprehending patients' symptom information, as it primarily exists in narrative forms in various parts of the electronic health record. This variability raises concerns about over- or under-reporting of symptoms. Consistency between patient-reported symptoms and clinician's symptom documentation is important for patient-centered symptom management, but little is known about the degree of agreement between patient reports and their documentation. This is a detailed description of the study's methodology, procedures and design to determine how patient-reported symptoms are similar or different from symptoms documented in electronic health records by clinicians. DESIGN Exploratory, descriptive study. METHODS Forty symptoms will be assessed as patient-reported outcomes using the modified version of the Memorial Symptom Assessment Scale. The research team will annotate symptoms from the electronic health record (clinical notes and flowsheets) corresponding to the 40 symptoms. The degree of agreement between patient reports and electronic health record documentation will be analyzed using positive and negative agreement, kappa statistics and McNemar's test. CONCLUSION We present innovative methods to comprehensively compare the symptoms reported by acute myeloid leukemia patients with all available electronic health record documentation, including clinical notes and flowsheets, providing insights into symptom reporting in clinical practice. IMPACT Findings from this study will provide foundational understanding and compelling evidence, suggesting the need for more thorough efforts to assess patients' symptoms. Methods presented in this paper are applicable to other symptom-intensive diseases.
Collapse
Affiliation(s)
- Sena Chae
- College of Nursing, The University of Iowa, Iowa City, Iowa, USA
| | - Jaewon Bae
- College of Nursing, The University of Iowa, Iowa City, Iowa, USA
| | - Nayung Youn
- College of Nursing, The University of Iowa, Iowa City, Iowa, USA
| | - Karen Dunn Lopez
- College of Nursing, The University of Iowa, Iowa City, Iowa, USA
| | - Grerk Sutamtewagul
- Internal Medicine-Hematology, Oncology, and Blood and Marrow Transplantation, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Barbara Rakel
- College of Nursing, The University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
9
|
Sung C, Park CG, Maienschein-Cline M, Chlipala G, Green S, Doorenbos A, Fink A, Bronas U, Lockwood M. Associations Between Gut Microbial Features and Sickness Symptoms in Kidney Transplant Recipients. Biol Res Nurs 2024; 26:368-379. [PMID: 38231673 DOI: 10.1177/10998004241227560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE The study investigated the relationship of gut microbiome features and sickness symptoms in kidney transplant recipients. METHODS Employing a prospective, longitudinal design, we collected data from 19 participants who had undergone living-donor kidney transplant at three timepoints (pre-transplant and 1 week and 3 months post-transplant). Sickness symptom data and fecal specimens were collected at each timepoint. Participants were grouped either as high or low sickness symptom severity at baseline. Shotgun metagenomics sequencing characterized gut microbial structure and functional gene content. Fecal microbial features, including alpha (evenness and richness within samples) and beta (dissimilarities between samples) diversity and relative abundances, were analyzed using R statistical packages. Cross-sectional and longitudinal analyses examined relationships between gut microbial features and sickness symptoms. RESULTS Although our exploratory findings revealed no significant differences in alpha and beta diversity between groups, the high-severity group showed lower microbial richness and evenness than the low-severity group. The high-severity group had enriched relative abundance of bacteria from the genera Citrobacter and Enterobacter and reduced relative abundance of bacteria from the genus Akkermansia across timepoints. No functional genes differed significantly between groups or timepoints. CONCLUSIONS Kidney transplant recipients with high symptom burden displayed increased putative proinflammatory bacteria and decreased beneficial bacteria. This study provides an effect size that future large cohort studies can employ to confirm associations between gut microbial features and sickness symptom experiences in the kidney transplant population. The study findings also have implications for future interventional studies aiming to alleviate the sickness symptom burden in this population.
Collapse
Affiliation(s)
- Choa Sung
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Chang Gi Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - George Chlipala
- Associate Director of Research Informatics Core, University of Illinois at Chicago, Chicago, IL, USA
| | - Stefan Green
- Department of Internal Medicine, Division of Infectious Disease, Rush University Medical Center, Chicago, IL, USA
| | - Ardith Doorenbos
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Anne Fink
- Biobehavioral Science in Nursing and Rehabilitation & Regenerative Medicine, Columbia University, New York, NY, USA
| | - Ulf Bronas
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Mark Lockwood
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| |
Collapse
|
10
|
Luo Y, Luo J, Su Q, Yang Z, Miao J, Zhang L. Exploring Central and Bridge Symptoms in Patients with Lung Cancer: A Network Analysis. Semin Oncol Nurs 2024; 40:151651. [PMID: 38704342 DOI: 10.1016/j.soncn.2024.151651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES This study aimed to identify symptom clusters in lung cancer patients undergoing chemotherapy and the central and bridge symptoms within each symptom cluster. METHODS In this cross-sectional study, 1,255 patients with lung cancer were recruited through convenience sampling at Nanfang Hospital. Patient symptom burden was assessed using the M.D. Anderson Symptom Inventory (MDASI) and the Lung Cancer module of the MDASI (MDASI-LC). Symptom clusters were identified using the Walktrap algorithm, and central and bridge symptoms in the symptom clusters were identified by network analysis. RESULTS The patients included 818 (65.18%) males and 437 (34.82%) females with a mean age of 56.56 ± 11.78 years. Four symptom clusters were identified: fatigue, gastrointestinal, psychoneurological and respiratory. Their central symptoms were fatigue, vomiting, distress and hemoptysis, respectively, and their bridge symptoms were pain, vomiting, dry mouth and shortness of breath. CONCLUSIONS Lung cancer symptoms show certain strong correlations with each other, resulting in symptom clusters. Central symptoms may influence other symptoms within a symptom cluster, and bridge symptoms might impact the density of the symptom network. This study identified central and bridge symptoms in lung cancer patients undergoing chemotherapy. Targeting these symptoms with interventions for symptom clusters could make symptom management more precise and effective. IMPLICATIONS FOR NURSING PRACTICE In clinical settings, the burden of symptom clusters may be reduced by intervening against the central symptoms of these symptom clusters. Alternatively, if the objective is to diminish the connections between different symptom clusters and holistically alleviate the overall burden, interventions focused on bridge symptoms may be employed.
Collapse
Affiliation(s)
- Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiahui Luo
- Nursing Department of Taikang Tongji (Wuhan) Hospital, Wuhan, Hubei, China
| | - Qing Su
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
| |
Collapse
|
11
|
Colomer-Lahiguera S, Gentizon J, Christofis M, Darnac C, Serena A, Eicher M. Achieving Comprehensive, Patient-Centered Cancer Services: Optimizing the Role of Advanced Practice Nurses at the Core of Precision Health. Semin Oncol Nurs 2024; 40:151629. [PMID: 38584046 DOI: 10.1016/j.soncn.2024.151629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES The field of oncology has been revolutionized by precision medicine, driven by advancements in molecular and genomic profiling. High-throughput genomic sequencing and non-invasive diagnostic methods have deepened our understanding of cancer biology, leading to personalized treatment approaches. Precision health expands on precision medicine, emphasizing holistic healthcare, integrating molecular profiling and genomics, physiology, behavioral, and social and environmental factors. Precision health encompasses traditional and emerging data, including electronic health records, patient-generated health data, and artificial intelligence-based health technologies. This article aims to explore the opportunities and challenges faced by advanced practice nurses (APNs) within the precision health paradigm. METHODS We searched for peer-reviewed and professional relevant studies and articles on advanced practice nursing, oncology, precision medicine and precision health, and symptom science. RESULTS APNs' roles and competencies align with the core principles of precision health, allowing for personalized interventions based on comprehensive patient characteristics. We identified educational needs and policy gaps as limitations faced by APNs in fully embracing precision health. CONCLUSION APNs, including nurse practitioners and clinical nurse specialists, are ideally positioned to advance precision health. Nevertheless, it is imperative to overcome a series of barriers to fully leverage APNs' potential in this context. IMPLICATIONS FOR NURSING PRACTICE APNs can significantly contribute to precision health through their competencies in predictive, preventive, and health promotion strategies, personalized and collaborative care plans, ethical considerations, and interdisciplinary collaboration. However, there is a need to foster education in genetics and genomics, encourage continuous professional development, and enhance understanding of artificial intelligence-related technologies and digital health. Furthermore, APNs' scope of practice needs to be reflected in policy making and legislation to enable effective contribution of APNs to precision health.
Collapse
Affiliation(s)
- Sara Colomer-Lahiguera
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jenny Gentizon
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Melissa Christofis
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Célia Darnac
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Andrea Serena
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
12
|
Chang G, Lin X, Qin M, Wang L, Cai S. Symptom cluster study undergoing chemotherapy in breast cancer patients: Latent class analysis and contemporaneous network analysis. Asia Pac J Oncol Nurs 2024; 11:100499. [PMID: 38975611 PMCID: PMC11225815 DOI: 10.1016/j.apjon.2024.100499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/27/2024] [Indexed: 07/09/2024] Open
Abstract
Objective This study aims to explore the subgroups and networks of symptom clusters in breast cancer patients undergoing chemotherapy, and to provide effective interventions for the core symptoms. Methods A cross-sectional survey was conducted at four comprehensive hospitals in Foshan City, China, from August to November 2023. A total of 292 participants completed the social determinants of health questionnaire, the numerical rating scale (NRS), the Pittsburgh sleep quality index (PSQI), the Chinese version of the cancer fatigue scale (CFS), and the hospital anxiety and depression Scale (HADS). Latent class analysis (LCA) was utilized to distinguish subgroups, and network analysis was utilized to identify core symptoms among different subgroups. Results Breast cancer patients undergoing chemotherapy exhibit symptoms were divided into two subgroups: the high burden group of symptoms (72.3%, Class 1) and the low burden group of symptoms (27.7%, Class 2). Education attainment, work status, family monthly income per capita, and daily sleep duration (hours) were associated with subgroup membership. "Panic feelings" (# HADS-A11) were the core symptom in both the full sample and Class 2, while "tension or pain" (# HADS-A1) was the core symptom in Class 1. Conclusions The core symptoms of fear, enjoyment, nervousness, and pain varied across subgroups of patients and could inform the current strategies for symptom management in breast cancer chemotherapy patients.
Collapse
Affiliation(s)
| | | | - Meijiao Qin
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Lixia Wang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shu Cai
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| |
Collapse
|
13
|
Kwon KK, Lacey J, Kerin-Ayres K, Heller G, Grant S. Acupuncture for the treatment of the pain-fatigue-sleep disturbance-numbness/tingling symptom cluster in breast cancer survivors: a feasibility trial. Support Care Cancer 2024; 32:332. [PMID: 38713422 PMCID: PMC11076364 DOI: 10.1007/s00520-024-08529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Breast cancer survivors following disease-modifying treatment frequently experience multiple-concurrent symptoms (Jansana et al. in Int J Cancer 149(10):1755 1767, 2021), negatively impacting their quality of life and increasing the risk of polypharmacy (Alwhaibi et al. in J Oncol Pharm Pract 26(5):1052 1059, 2020). This study evaluates the feasibility and acceptability of acupuncture for the management of the pain-fatigue-sleep disturbance-numbness/tingling symptom cluster in breast cancer survivors, and investigates relationships between the symptom cluster and Traditional Chinese Medicine (TCM) syndrome diagnosis. METHODS This was a single-arm, pre-test/post-test feasibility trial conducted at Chris O'Brien Lifehouse Hospital, Australia. Breast cancer survivors who completed treatment and experienced clinically significant levels of two or more symptoms (pain, fatigue, sleep disturbance, numbness/tingling) were eligible to participate in the individualized, pragmatic 6-week acupuncture intervention. The primary outcome was feasibility and acceptability. Effectiveness was explored using a symptom cluster mean score. RESULTS Twenty women enrolled in the study over an 11-week period and 90% completed the study. Most women agreed or completely agreed that acupuncture was feasible (85%), acceptable (90%), and appropriate (90%). Both mean and composite symptom cluster scores were significantly reduced (p < 0.001), as were individual symptom scores in fatigue (p < 0.001), sleep disturbance (p = 0.04), and numbness/tingling (p = 0.01). TCM syndromes most closely associated with this symptom cluster were Spleen qi deficiency and Heart fire. No adverse events were reported. CONCLUSION This study demonstrated that acupuncture was safe and feasible, justifying a powered randomized control trial. Preliminary findings suggest beneficial effects of acupuncture for the management of the pain-fatigue-sleep disturbance-numbness/tingling symptom cluster for women with breast cancer. TCM syndromes identified in this trial may be used to guide acupuncture treatment protocols. CLINICAL TRIAL REGISTRATION This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000590763) on 21 April 2022.
Collapse
Affiliation(s)
- Ki Kyung Kwon
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia.
| | - Judith Lacey
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Kim Kerin-Ayres
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
| | - Gillian Heller
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Chris O'Brien Lifehouse Hospital, Camperdown, NSW, Australia
| |
Collapse
|
14
|
Brazauskas R, Flynn K, Krishnan A, Landau H, Giralt S, Pasquini MC, Stadtmauer EA, D’Souza A. Symptom clusters and their impact on quality of life in multiple myeloma survivors: Secondary analysis of BMT CTN 0702 trial. Br J Haematol 2024; 204:1429-1438. [PMID: 38348544 PMCID: PMC11006567 DOI: 10.1111/bjh.19326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 04/11/2024]
Abstract
Autologous haematopoietic cell transplantation (autoHCT) and continuous post-transplant maintenance therapy are the standard of care in transplant-eligible multiple myeloma (MM) patients. We sought to describe symptom burden and identify symptom clusters occurring in MM patients after autoHCT using data from the BMT CTN 0702 randomized controlled trial comparing the outcomes of three treatment interventions after an autoHCT in 758 MM patients. We analysed individual transplant-related symptoms assessed via the FACT-BMT questionnaire at enrolment and annually for 4-year post-autoHCT. We also described the effect the individual symptoms and symptom clusters have on quality of life (QoL). We identified three stable symptom clusters: malaise symptom cluster (lack of energy, feeling ill, having pain, experiencing nausea, loss of appetite), physical symptom cluster (having skin problems, tremors, worsening eyesight, change in taste, shortness of breath, frequent colds) and emotional symptom cluster (feeling sad, being nervous, experiencing sleep problems). Malaise and emotional symptom clusters have a greater impact on QoL than the physical symptoms cluster. Identifying these symptoms warrant additional support in terms of psychosocial support, in addition to treatment of the physical symptoms themselves.
Collapse
Affiliation(s)
- Ruta Brazauskas
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kathryn Flynn
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amrita Krishnan
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Cancer Center, Duarte, CA, USA
| | - Heather Landau
- Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sergio Giralt
- Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marcelo C Pasquini
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Edward A Stadtmauer
- Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anita D’Souza
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
15
|
Wiranata JA, Hutajulu SH, Astari YK, Leo B, Bintoro BS, Hardianti MS, Taroeno-Hariadi KW, Kurnianda J, Purwanto I. Patient-reported outcomes and symptom clusters pattern of chemotherapy-induced toxicity in patients with early breast cancer. PLoS One 2024; 19:e0298928. [PMID: 38394281 PMCID: PMC10890761 DOI: 10.1371/journal.pone.0298928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVE This study aims to characterize patient-reported chemotherapy-induced toxicity in patients with breast cancer, determine its association with treatment regimens and patient characteristics, identify toxicity symptom clusters within a specific chemotherapy timeframe and analyze the correlation between symptom clusters within and between the timeframe to understand the changes and influences across chemotherapy. METHODS Forty-six patient-reported toxicities during neoadjuvant/adjuvant chemotherapy for breast cancer were evaluated using adapted CTCAE version 4.0. Chi-Square/Fisher's Exact test was performed to analyze the difference in the incidence of toxicity symptoms by chemotherapy regimens. Poisson regression performed to assess factors associated with patient's total chemotherapy toxicity. Exploratory factor analysis (EFA) conducted to identify symptom clusters at T1 (first half) and T2 (second half of planned cycle). Factor scores were generated and Spearman correlation performed to explore the factor scores correlation between symptom clusters. RESULTS A total of 142 patients with stage I-III breast cancer were included. The incidence of several toxicities differed significantly among three chemotherapy regimens. Subjects age ≥51 years are associated with lower number of reported toxicity (IRR/incidence rate ratio = 0.94, 95% confidence interval/CI 0.88 to 0.99, p = 0.042). Receiving more chemotherapy cycles are associated with higher number of reported toxicity (IRR = 1.06, 95% CI 1.03 to 1.10, p<0.001). Two symptom clusters identified at T1 (psychoneurological-pain/PNP-T1 and gastrointestinal-psychological/GIP-T1 cluster) and three at T2 (psychoneurological-pain/PNP-T2, epithelial/EPI-T2, and gastrointestinal cluster/GI-T2), with moderate-strong positive correlation between PNP-T1 and GIP-T2 (p<0.001), PNP-T1 and PNP-T2 (p<0.001), and GIP-T1 and PNP-T2 (p<0.001). CONCLUSIONS This study investigated 46 patient-reported toxicities prospectively during adjuvant/neoadjuvant chemotherapy for early breast cancer. Anthracycline-taxane combination regimen had higher proportions of toxicity incidence. Subject's age and number of chemotherapy cycles significantly associated with total number of toxicity symptoms. Two symptom clusters at T1 and three at T2 were identified, with significant correlation between symptom clusters within and between chemotherapy timeframe.
Collapse
Affiliation(s)
- Juan Adrian Wiranata
- Clinical Epidemiology Study Program, Master of Clinical Medicine Postgraduate Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Yufi Kartika Astari
- Research Scholar, Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Benedreky Leo
- Specialty Program in Internal Medicine, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bagas Suryo Bintoro
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mardiah Suci Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kartika Widayati Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| |
Collapse
|
16
|
Almeida AM, Lima L, Martins T. Monitoring Patient-Reported Outcomes in Self-management of Postsurgical Symptoms in Oncology: A Scoping Review. Cancer Nurs 2024; Publish Ahead of Print:00002820-990000000-00147. [PMID: 37232525 DOI: 10.1097/ncc.0000000000001250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Surgery is used widely for cancer treatment, and in most types, after discharge, patients usually report multiple symptoms, which, if not controlled, can put postoperative recovery at risk. Understanding which patient-reported outcomes (PROs) should be monitored could have a significant impact on reducing the symptom burden associated with cancer and its treatment by playing a pivotal role in developing symptom self-management plans and designing tailored approaches to optimize patients' symptom self-management behaviors. OBJECTIVE To map the PROs used for patients' postsurgical symptom self-management after hospital discharge following cancer surgery. INTERVENTIONS/METHODS Our scoping review process was guided by the steps for conducting scoping reviews recommended by the Joanna Briggs Institute. RESULTS The search identified 97 potentially relevant studies, with 27 articles meeting the inclusion criteria. The most frequently assessed and monitored PROs were problems with surgical wounds, more general physical symptoms, psychological functioning outcomes, and quality of life. CONCLUSIONS Our results showed an overall uniformity among the PROs selected to be monitored in surgical cancer patients after hospital discharge. Monitoring through electronic platforms is widely used and seems useful to self-manage symptoms and optimize the recovery of cancer patients after discharge following surgery. IMPLICATIONS FOR PRACTICE This study provides knowledge about PROs that can be applied in oncologic patients after surgery to self-report their symptoms following discharge.
Collapse
Affiliation(s)
- Ana M Almeida
- Author Affiliations: Institute of Biomedical Sciences Abel Salazar of the University of Porto-ICBAS (Mrs Almeida); Imaging Sciences and Radiooncology Department, Portuguese Institute of Oncology of Porto (Mrs Almeida); Nursing School of Porto (Drs Martins and Lima); and Center for Health Technology and Services Research, (CINTESIS@RISE)(Drs Martins and Lima), Porto, Portugal
| | | | | |
Collapse
|
17
|
Ye Y, Zeng K, Qin L, Luo J, Liu S, Miao J, Liang J, Yu Y, Zhao M, Zhang L. Differential Characteristics of Fatigue-Pain-Sleep Disturbance-Depression Symptom Cluster and Influencing Factors of Patients With Advanced Cancer During Treatment: A Latent Class Analysis. Cancer Nurs 2024:00002820-990000000-00206. [PMID: 38206596 DOI: 10.1097/ncc.0000000000001316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Patients with advanced cancer may experience symptom clusters during treatment (eg, fatigue, pain, sleep disturbance, depression). Understanding the characteristics and factors associated with symptom cluster classes among this patient population is essential for effective symptom management. OBJECTIVE The aims of this study were to identify symptom cluster (fatigue-pain-sleep disturbance-depression) classes and explore influencing factors in patients with advanced cancer during the treatment. METHODS A cross-sectional survey was conducted in an oncology department of a tertiary hospital in China from September 2020 to March 2021. Cancer patients (stage III/IV) 18 years or older completed the questionnaires on pain, fatigue, sleep disturbance, depression, physical activity, and exercise self-efficacy. Latent class analysis and multinomial logistic regression were used. RESULTS Three hundred sixty-five patients who were male (65.2%) and younger than 60 years (59.5%) completed questionnaires. Three symptom cluster classes were identified: class 1 ("low symptom burden" class), class 2 ("fatigue-insomnia" class), and class 3 ("high symptom burden" class), with a percentage of 54.5%, 38.6%, and 6.8%, respectively. The quality-of-life score, introversion/extroversion, economic burden, Karnofsky Performance Status, albumin level, and exercise self-efficacy were significantly different among the 3 classes (P < .05). CONCLUSION Patients with advanced cancer were classified into 3 distinct classes, with class 1 having the best function. Results from this study reveal that Karnofsky Performance Status, albumin level, and exercise self-efficacy were significant factors for the latent classes of symptom cluster. IMPLICATIONS FOR PRACTICE Exercise self-efficacy is important for personalized interventions and improving symptom management efficiency.
Collapse
Affiliation(s)
- Yanxin Ye
- Author Affiliations: School of Nursing, Southern Medical University (Drs Ye, Zeng, Qin, Luo, Liu, Liang, and Zhang); Nanfang Hospital, the First Hospital Affiliated to Southern Medical University (Mrs Miao); Guangzhou First People's Hospital, the Second Hospital Affiliated to Southern China University of Technology (Dr Yu); and School of Basic Medical Sciences, Southern Medical University (Dr Zhao), Guangzhou, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Grégoire C, Baussard L, Ernst M, Diep A, Faymonville ME, Devos M, Jerusalem G, Vanhaudenhuyse A. Evaluation of a psychoneurological symptom cluster in patients with breast or digestive cancer: a longitudinal observational study. BMC Cancer 2024; 24:51. [PMID: 38195471 PMCID: PMC10777491 DOI: 10.1186/s12885-023-11799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND A psychoneurological symptom cluster composed of cancer-related fatigue, emotional distress, sleep difficulties, and pain is very common among patients with cancer. Cognitive difficulties are also frequently associated with this cluster. Network analyses allow for an in-depth understanding of the relationships between symptoms in a cluster. This paper details the study protocol of a longitudinal assessment of the psychoneurological symptom cluster in two distinct cohorts: breast cancer and digestive cancer survivors, using network analyses. METHODS Over two years, the symptoms involved in the psychoneurological symptom cluster, along with other common symptoms (e.g., digestive symptoms, financial difficulties) and variables (i.e., self-compassion, coping strategies) will be assessed in two cohorts: breast cancer survivors (N = 240) and digestive cancer survivors (N = 240). Online questionnaires will be completed at baseline, then 6, 12 and 24 months later. Network analyses will be used to assess the configuration of the symptom cluster at each measurement time and in each cohort. Comparison of networks between two measurement times or between the two cohorts will also be done with network comparison tests. DISCUSSION This study will enable a better understanding of the relationships between common symptoms endured by patients with cancer. The results will be employed to develop more cost-effective interventions which, ultimately, will significantly improve the quality of life of patients with breast or digestive cancer. TRIAL REGISTRATION ClinicalTrials.gov (NCT05867966). Registered on the 27th of April 2023. url: https://classic. CLINICALTRIALS gov/ct2/show/NCT05867966 .
Collapse
Affiliation(s)
- Charlotte Grégoire
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium.
| | | | - Marie Ernst
- Biostatistics and Research Method Center, University Hospital and University of Liège, Liège, Belgium
| | - Anh Diep
- Biostatistics and Research Method Center, University Hospital and University of Liège, Liège, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
- Arsène Burny Cancerology Institute, University Hospital of Liège, Liège, Belgium
| | - Martine Devos
- Arsène Burny Cancerology Institute, University Hospital of Liège, Liège, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, University Hospital and University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
- Algology Interdisciplinary Center, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
19
|
Moosivand S, Nazari O, Shahverdi A, Gholami M, Mohammadi R, Yarahmadi S. Predictors of emotional intelligence among family caregivers of cancer patients: A cross-sectional study. Cancer Rep (Hoboken) 2024; 7:e1943. [PMID: 37990763 PMCID: PMC10809196 DOI: 10.1002/cnr2.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/01/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Family caregivers of cancer patients must have strong emotional intelligence skills essential for understanding one's and others' feelings and learning how to cope. OBJECTIVES The present study aims to determine the predictive factors of emotional intelligence and its relationship with spiritual intelligence, coping, and knowledge and experience about pain among family caregivers of cancer patients in Iran. METHODS A cross-sectional, descriptive study was conducted in 2020-2021. Two hundred twenty-six family caregivers of cancer patients participated in this study. The data collection tools were Wong and Law's emotional intelligence, King's spiritual intelligence, Brief Cope, and the family pain questionnaire. Following determining the variables' correlation, linear regression was carried out. RESULTS Emotional intelligence had a significant correlation with age (r = 0.20, p = .003), academic degree (r = 0.15, p = .032), duration of care (r = 0.15, p = .032), and spiritual intelligence (r = 0.30, p < .001). The regression model accounted for 12.4% of the variance in emotional intelligence; age (β = 0.16, p < .021) and spiritual intelligence (β = 0.26, p < .001) were significant explanatory variables. CONCLUSIONS Emotional intelligence is correlated with age, academic degree, duration of care, and spiritual intelligence, but only age and spiritual intelligence were found to be predictive factors for emotional intelligence in the family caregivers of cancer patients.
Collapse
Affiliation(s)
- Shakiba Moosivand
- Student Research Committee, School of Nursing and MidwiferyLorestan University of Medical SciencesKhorramabadIran
| | - Omid Nazari
- Student Research Committee, School of Nursing and MidwiferyLorestan University of Medical SciencesKhorramabadIran
| | - Ali Shahverdi
- Student Research Committee, School of Nursing and MidwiferyLorestan University of Medical SciencesKhorramabadIran
| | - Mohammad Gholami
- Social Determinants of Health Research Center, School of Nursing and MidwiferyLorestan University of Medical SciencesKhorramabadIran
| | - Rasool Mohammadi
- Nutritional Health Research Center, School of Health and NutritionLorestan University of Medical SciencesKhorramabadIran
| | - Sajad Yarahmadi
- Social Determinants of Health Research Center, School of Nursing and MidwiferyLorestan University of Medical SciencesKhorramabadIran
- Student Research CommitteeSemnan University of Medical SciencesSemnanIran
| |
Collapse
|
20
|
Liang M, Ye Z. Patient-reported outcome measures in cancer care: Integration with computerized adaptive testing. Asia Pac J Oncol Nurs 2023; 10:100323. [PMID: 38033390 PMCID: PMC10686812 DOI: 10.1016/j.apjon.2023.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Minyu Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
21
|
Pelizzola M, Tanderup K, Chopra S, Jürgenliemk-Schulz IM, Nout R, Kirchheiner K, Spampinato S. Co-occurrence of symptoms after radiochemotherapy in locally advanced cervix cancer patients: a cluster analysis. Acta Oncol 2023; 62:1479-1487. [PMID: 37906286 DOI: 10.1080/0284186x.2023.2271252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/06/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND State of the art combined radiochemotherapy and image-guided brachytherapy for locally advanced cervical cancer (LACC) has shown improved disease control and survival as well as a significant reduction of organ related morbidity. However, LACC cancer survivors are still experiencing a spectrum of symptoms. The aim of this study was to identify co-occurring symptoms in cervix cancer survivors by using patient-reported outcome and physician assessed morbidity. MATERIALS AND METHOD EMBRACE I is a multicenter prospective observational study with 1416 LACC patients (2008-2015). Information on physician-assessed morbidity and patient-reported outcome was assessed at baseline and at regular follow-ups up with the CTCAE v.3 and EORTC-C30/CX24, respectively. Patients with at least 2 years of follow-up were included and data from 3 months to 2 years was used in the analysis. Factor analysis was used on both EORTC and CTCAE data with symptoms and follow-ups as observations. The extracted factors represent clusters of symptoms. Subsequently, regression models were built to investigate associations between the symptom clusters and QOL. RESULTS The analysis included 742 patients. Despite the differences in the definition of physician-assessed and patient-reported symptoms, similar clusters are identified by the two assessment methods. Three main organ-related clusters are recognized for urinary, gastro-intestinal and vaginal morbidity. Furthermore, a general symptoms cluster where fatigue, pain, insomnia, neuropathy, and hot flashes have large weights is found. Lastly, a cluster with nausea, vomit and lack of appetite is also identified. The general, gastrointestinal and nausea clusters show significant associations with general QOL. CONCLUSIONS This analysis on both PRO and physician-assessed morbidity found a cluster associated with general symptoms and organ-related symptom clusters (urinary, gastrointestinal, vaginal). This shows that LACC survivors experience a variety of co-occurring symptoms. Our analysis also shows that the cluster of general symptoms is associated with a decrease in QOL.
Collapse
Affiliation(s)
- Marta Pelizzola
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Kari Tanderup
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Supriya Chopra
- Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India
| | - Ina M Jürgenliemk-Schulz
- Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht, CX, The Netherlands
| | - Remi Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Kathrin Kirchheiner
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Sofia Spampinato
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
22
|
Zeng L, Huang H, Qirong C, Ruan C, Liu Y, An W, Guo Q, Zhou J. Multiple myeloma patients undergoing chemotherapy: Which symptom clusters impact quality of life? J Clin Nurs 2023; 32:7247-7259. [PMID: 37303229 DOI: 10.1111/jocn.16791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/12/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
AIMS AND OBJECTIVES To identify symptom clusters and examine their association with health-related quality of life. BACKGROUND Multiple myeloma patients undergoing chemotherapy suffer from disease symptoms and adverse effects during the course of the disease. However, single symptom management has little effect, and symptom management for these patients remains challenging. Symptom clusters open a new perspective and provide important clues for symptom management. DESIGN A cross-sectional study. METHOD Participants were invited to complete the Chinese version of the Memorial Symptom Assessment Scale and Quality of Life Questionnaire-core 30. Appropriate indicators were used for descriptive statistics. Principal component analysis was used to identify symptom clusters. Associations between symptom clusters and quality of life were examined with Pearson correlation coefficients, Pearson correlation matrix and multiple linear regression. This study was reported following the STROBE checklist. RESULTS A total of 177 participants were recruited from seven hospitals in this study. We identified self-image disorder, psychological, gastrointestinal, neurological, somatic and pain symptom clusters in multiple myeloma patients with chemotherapy. Approximately 97.65% of patients suffer from multiple symptom clusters. The pain, psychological and gastrointestinal symptom clusters have negatively influence on health-related quality of life. The strongest association was found with the pain symptom cluster. CONCLUSION Most of multiple myeloma patients suffer from multiple symptom clusters. When improving the multiple myeloma patients' health-related quality of life, the clinical staff should prioritise relieving the pain symptom cluster. RELEVANCE TO CLINICAL PRACTICE When multiple myeloma patients undergoing chemotherapy suffer from multiple symptom clusters, nurses should prioritise relieving the pain symptom cluster to improve their health-related quality of life. When drawing up and providing interventions, nurses should focus on the correlation among symptoms rather than single symptom. By relieving one symptom in a given cluster, other symptoms within the same symptom cluster may also be relieved.
Collapse
Affiliation(s)
- Lihong Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Huang
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chen Qirong
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chunhong Ruan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yaqi Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wenhong An
- School of Health and Wellness, Panzhihua University, Sichuan, China
| | - Qinqin Guo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiandang Zhou
- The Third Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
23
|
Scharp D, Harkins SE, Topaz M. Comorbidities of community-dwelling older adults with urinary incontinence: A scoping review. Geriatr Nurs 2023; 53:280-294. [PMID: 37598432 PMCID: PMC10529939 DOI: 10.1016/j.gerinurse.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Identifying comorbidities is a critical first step to building clinical phenotypes to improve assessment, management, and outcomes. OBJECTIVES 1) Identify relevant comorbidities of community-dwelling older adults with urinary incontinence, 2) provide insights about relationships between conditions. METHODS PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched. Eligible studies had quantitative designs that analyzed urinary incontinence as the exposure or outcome variable. Critical appraisal was performed using the Joanna Briggs Institute Critical Appraisal Checklists. RESULTS Ten studies were included. Most studies had methodological weaknesses in the measurement of conditions. Comorbidities affecting the neurologic, cardiovascular, psychologic, respiratory, endocrine, genitourinary, and musculoskeletal systems were found to be associated with urinary incontinence. CONCLUSION Existing literature suggests that comorbidities and urinary incontinence are interrelated. Further research is needed to examine symptoms, shared mechanisms, and directionality of relationships to generate clinical phenotypes, evidence-based holistic care guidelines, and improve outcomes.
Collapse
Affiliation(s)
- Danielle Scharp
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, United States.
| | - Sarah E Harkins
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, United States.
| | - Maxim Topaz
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, United States.
| |
Collapse
|
24
|
Danielsen JT, Strøm L, Knutzen SM, Schmidt H, Amidi A, Wu LM, Zachariae R. Psychological and behavioral symptoms in patients with melanoma: A systematic review and meta-analysis. Psychooncology 2023; 32:1208-1222. [PMID: 37370196 DOI: 10.1002/pon.6184] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE Improved survival rates have made it increasingly important for clinicians to focus on cancer survivorship issues affecting the quality of life of melanoma patients. To provide a comprehensive overview of the disease and treatment-related issues affecting such patients, we conducted a systematic review and meta-analysis of the literature to estimate the prevalence of symptoms of depression, anxiety, fatigue, sleep disturbance, and cognitive problems among melanoma patients, both uveal and cutaneous, before, during and after treatment. METHODS The review was preregistered with PROSPERO (#CRD42020189847) and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of the literature published up until June 2022 was undertaken using PubMed, PsycInfo, the Cochrane Library, and CINAHL. Two independent reviewers screened 1418 records and quality-rated included studies. The reported prevalence rates of symptoms were pooled using a random-effects model. RESULTS Sixty-six studies including a total of 12,400 melanoma patients published between 1992 and 2022 were included. Pooled prevalence rates ranged from 6% to 16% for depression and 7%-30% for anxiety across diagnoses (uveal and cutaneous melanoma) and assessment time points. One third of the patients (35%) reported clinically significant fatigue, 20%-44% had cognitive complaints, while prevalence of sleep disturbance was not reported. Quality assessment indicated that 80% of the studies were of good quality. CONCLUSION A large body of research shows that depression and anxiety symptoms are prevalent in melanoma patients before, during and after treatment. However, research examining other symptoms known to affect quality of life, such as fatigue, sleep disturbances, and cognitive problems, is still needed.
Collapse
Affiliation(s)
- Josefine T Danielsen
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Louise Strøm
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Sofie M Knutzen
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Henrik Schmidt
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Lisa M Wu
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| |
Collapse
|
25
|
Wojeck RK, Knisely MR, Bailey DE, Somers TJ, Kwakkenbos L, Carrier ME, Nielson WR, Bartlett SJ, Malcarne VL, Hudson M, Levis B, Benedetti A, Mouthon L, Thombs BD, Silva SG. Patterns of patient-reported symptoms and association with sociodemographic and systemic sclerosis disease characteristics: a scleroderma Patient-centered Intervention Network (SPIN) Cohort cross-sectional study. EClinicalMedicine 2023; 62:102104. [PMID: 37533421 PMCID: PMC10393558 DOI: 10.1016/j.eclinm.2023.102104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
Background Systemic sclerosis is a heterogenous disease in which little is known about patterns of patient-reported symptom clusters. We aimed to identify classes of individuals with similar anxiety, depression, fatigue, sleep disturbance, and pain symptoms and to evaluate associated sociodemographic and disease-related characteristics. Methods This multi-centre cross-sectional study used baseline data from Scleroderma Patient-centered Intervention Network Cohort participants enrolled from 2014 to 2020. Eligible participants completed the PROMIS-29 v2.0 measure. Latent profile analysis was used to identify homogeneous classes of participants based on patterns of anxiety, depression, fatigue, sleep disturbance, and pain scores. Sociodemographic and disease-related characteristics were compared across classes. Findings Among 2212 participants, we identified five classes, including four classes with "Low" (565 participants, 26%), "Normal" (651 participants, 29%), "High" (569 participants, 26%), or "Very High" (193 participants, 9%) symptom levels across all symptoms. Participants in a fifth class, "High Fatigue/Sleep/Pain and Low Anxiety/Depression" (234 participants, 11%) had similar levels of fatigue, sleep disturbance, and pain as in the "High" class but low anxiety and depression symptoms. There were significant and substantive trends in sociodemographic characteristics (age, education, race or ethnicity, marital or partner status) and increasing disease severity (diffuse disease, tendon friction rubs, joint contractures, gastrointestinal symptoms) across severity-based classes. Disease severity and sociodemographic characteristics of "High Fatigue/Sleep/Pain and Low Anxiety/Depression" class participants were similar to the "High" severity class. Interpretation Most people with systemic sclerosis can be classified by levels of patient-reported symptoms, which are consistent across symptoms and highly associated with sociodemographic and disease-related variables, except for one group which reports low mental health symptoms despite high levels of other symptoms and substantial disease burden. Studies are needed to better understand resilience in systemic sclerosis and to identify and facilitate implementation of cognitive and behavioural strategies to improve coping and overall quality of life. Funding National Institute of Nursing Research (F31NR019007), Canadian Institutes of Health Research, Arthritis Society Canada, the Lady Davis Institute for Medical Research, the Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland.
Collapse
Affiliation(s)
| | | | | | | | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Susan J. Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, California, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
| | - Susan G. Silva
- Duke University School of Nursing, Durham, North Carolina, USA
| |
Collapse
|
26
|
Reblin M, Iacob E, Tay DL, Li H, Hebdon MCT, Beck A, Donaldson G, Cloyes KG, Ellington L. Family Caregiver Reports of Their Own and Patient Symptoms in Cancer Home Hospice Approaching End-of-Life. Am J Hosp Palliat Care 2023; 40:508-516. [PMID: 35689339 PMCID: PMC9734284 DOI: 10.1177/10499091221108119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Context: Family caregivers assume the primary responsibility of assessing and managing hospice cancer patient symptoms while simultaneously managing their own wellbeing and symptoms. Objectives: Describe caregivers' assessment of hospice cancer patient and their own symptoms during the last 60 days of patient life, and assess the relationship between patient and caregiver symptoms over time. Methods: Caregiver symptom report of self and cancer home hospice patient symptom data were collected via telephone in the final 60 days of patient life. Descriptive data on symptom severity and prevalence were summarized. Exploratory Factor Analysis was used to group individual symptoms. Factors representing patient symptoms, caregiver symptoms, and caregiver outlook were analyzed using mixed-effects analysis to determine relationships between factors and change in relationship between factors over time. Results: Data from 61 patient-caregiver dyads are presented. At least 1 day of moderate-to-severe symptoms were reported in the majority of dyads. Significant auto-regressive associations were found, namely previous factor scores for an individual positively predicted the next factor scores for that individual. Previous caregiver report of patient symptoms was also positively associated with the next report of caregiver symptoms; previous caregiver report of their own symptoms were negatively associated with their next report of patient symptoms. Patient and caregiver symptoms and caregiver outlook worsened over time and the relationship between patient and caregiver symptoms strengthened closer to death. Conclusion: Our findings may guide hospice care team responses to caregiver and patient symptoms to promote individual level and unit level functioning.
Collapse
Affiliation(s)
- Maija Reblin
- School of Medicine, University of Vermont, Burlington, VT, USA
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Djin L. Tay
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Hui Li
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Gary Donaldson
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
27
|
Corasaniti MT, Bagetta G, Morrone LA, Tonin P, Hamamura K, Hayashi T, Guida F, Maione S, Scuteri D. Efficacy of Essential Oils in Relieving Cancer Pain: A Systematic Review and Meta-Analysis. Int J Mol Sci 2023; 24:7085. [PMID: 37108246 PMCID: PMC10138439 DOI: 10.3390/ijms24087085] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Over 80% of patients affected by cancer develops cancer-related pain, one of the most feared consequences because of its intractable nature, particularly in the terminal stage of the disease. Recent evidence-based recommendations on integrative medicine for the management of cancer pain underline the role of natural products. The present systematic review and meta-analysis aims at appraising for the first time the efficacy of aromatherapy in cancer pain in clinical studies with different design according to the most updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 recommendations. The search retrieves 1002 total records. Twelve studies are included and six are eligible for meta-analysis. The present study demonstrates significant efficacy of the use of essential oils in the reduction of the intensity of pain associated with cancer (p < 0.00001), highlighting the need for earlier, more homogeneous, and appropriately designed clinical trials. Good certainty body of evidence is needed for effective and safe management of cancer-related pain using essential oils by establishment of a step-by-step preclinical-to-clinical pathway to provide a rational basis for clinical use in integrative oncology. PROSPERO registration: CRD42023393182.
Collapse
Affiliation(s)
| | - Giacinto Bagetta
- Pharmacotechnology Documentation & Transfer Unit, Department of Pharmacy, Preclinical & Translational Pharmacology, Health & Nutritional Sciences, University of Calabria, 87036 Rende, Italy
| | - Luigi Antonio Morrone
- Pharmacotechnology Documentation & Transfer Unit, Department of Pharmacy, Preclinical & Translational Pharmacology, Health & Nutritional Sciences, University of Calabria, 87036 Rende, Italy
| | - Paolo Tonin
- Regional Center for Serious Brain Injuries, S. Anna Institute, 88900 Crotone, Italy
| | - Kengo Hamamura
- Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Takafumi Hayashi
- Laboratory of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Japan
| | - Francesca Guida
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
| | - Sabatino Maione
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
- IRCSS, Neuromed, 86077 Pozzilli, Italy
| | - Damiana Scuteri
- Pharmacotechnology Documentation & Transfer Unit, Department of Pharmacy, Preclinical & Translational Pharmacology, Health & Nutritional Sciences, University of Calabria, 87036 Rende, Italy
- Regional Center for Serious Brain Injuries, S. Anna Institute, 88900 Crotone, Italy
| |
Collapse
|
28
|
Ling F, Qi W, Li X, Zhou J, Xiong J, Zhao Y, Zheng Q, Liang F. Bibliometric Analysis of Acupuncture Therapy for Cancer Pain Over the Past 10 Years. J Pain Res 2023; 16:985-1003. [PMID: 36968762 PMCID: PMC10038162 DOI: 10.2147/jpr.s395421] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/28/2023] [Indexed: 03/21/2023] Open
Abstract
Purpose Cancer pain is a common symptom of cancer patients and greatly affects quality of life. Acupuncture has certain curative effects on cancer pain. The aim of this study was to analyze and visualize the current status and research trend of acupuncture treatment for cancer pain over the last 10 years and provide directions for future development. Methods A search of the Web of Science Core Collection from 2012-01-01 to 2022-08-20 was performed to collect studies related to acupuncture therapy for cancer pain. CiteSpace was used to conduct bibliometric analysis and visualization from the perspective of the volume of annual publications, journals, nations, institutions, authors, keywords, and references. Results A total of 302 studies were included in the analysis. The number of publications increased steadily with some fluctuations over the past decade. Integrative Cancer Therapies was the journal with the most relevant publications, and the Journal of Clinical Oncology was the most frequently cited journal. China had the highest volume of publications, and the USA contributed most to international collaboration. The most prolific institution was Memorial Sloan Kettering Cancer Center. The most productive author was Mao JJ, and the most influential author was Lu WD. "Acupuncture" was the top keyword in frequency and centrality. The references with the highest frequency and centrality were published by HE, Y, and Ting Bao, respectively. Conclusion A stable development trend has formed in this field. The overall collaborative network needs to be strengthened. Breast cancer and multiple myeloma, electroacupuncture and bee venom acupuncture, postoperative pain, peripheral neuropathic pain syndrome, and aromatase inhibitors-associated arthralgia syndrome are research hotspots in this field. Randomized controlled trials (RCTs), evidence-based evaluations and mechanisms (cancer-induced bone pain) are research trends and frontiers.
Collapse
Affiliation(s)
- Fayang Ling
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Wenchuan Qi
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Xiao Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Jun Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Jian Xiong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yi Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
- Qianhua Zheng, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China, Tel +86 189 0870 5127, Fax +86-028-87683962, Email
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China
- Correspondence: Fanrong Liang, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-028-87683962, Email
| |
Collapse
|
29
|
Abduljawad SF, Beckstead JW, Dobbs D, Visovsky C, Rodriguez CS, McMillan SC, Wang HL. Fatigue-related symptom clusters and functional status of older adults in hospice. Palliat Support Care 2023; 21:57-64. [PMID: 35676795 PMCID: PMC11022836 DOI: 10.1017/s1478951522000207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Fatigue is frequently co-existing with other symptoms and is highly prevalent among patients with cancer and geriatric population. There was a lack of knowledge that focus on fatigue clusters in older adults with cancer in hospice care. OBJECTIVES To identify fatigue-related symptom clusters in older adult hospice patients and discover to what extent fatigue-related symptom clusters predict functional status while controlling for depression. METHOD This was a cross-sectional study in a sample of 519 older adult hospice patients with cancer, who completed the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression, Boston Short Form Scale, and the Palliative Performance Scale. Data from a multi-center symptom trial were extracted for this secondary analysis using exploratory factor analysis and hierarchical multiple regression analysis. RESULTS Data from 519 patients (78 ± 7 years) with terminal cancer who received hospice care under home healthcare services revealed that 39% of the participants experienced fatigue-related symptom clusters (lack of energy, feeling drowsy, and lack of appetite). The fatigue cluster was significantly associated positively with depression (r = 0.253, p < 0.01), and negatively with functional status (r = -0.117, p < 0.01) and was a strong predictor of participants' low functional status. Furthermore, depression made a significant contribution to this predictive relationship. CONCLUSION Older adult hospice patients with cancer experienced various concurrent symptoms. The fatigue-specific symptom cluster was identified significantly associated with depression and predicted functional status. Fatigue should be routinely monitored in older adults, especially among hospice cancer patients, to help reduce psychological distress and prevent functional decline.
Collapse
Affiliation(s)
- Suzan F Abduljawad
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | | | - Debra Dobbs
- School of Aging Studies, University of South Florida, Tampa, FL
| | | | | | - Susan C McMillan
- Emeritus Distinguished Professor, University of South Florida, Tampa, FL
| | - Hsiao Lan Wang
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL
| |
Collapse
|
30
|
Liu C, Liu L, Chen M. Experience of living with symptom clusters in postoperative pancreatic cancer patients. Eur J Oncol Nurs 2023; 62:102266. [PMID: 36709717 DOI: 10.1016/j.ejon.2022.102266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of this study was to describe symptom clusters (SCs), and symptom experiences in early postoperative patients with pancreatic cancer who are recovering at home. METHODS From October 2021 and April 2022,15 patients following pancreatic cancer surgery were recruited from a tertiary hospital in Jiangsu Province by maximum variation sampling. Semi-structured interviews were performed to collect data and thematic analysis was conducted to analyze the data. RESULTS Three themes were extracted from the data. The first theme "difference in symptom perception and cognition" illustrated factors such as patient knowledge, expected recovery status, and risk perception could influence patient symptom experience. Most patients actually reported fewer and less severe symptoms than previous studies. The second theme "the results of symptom cluster" demonstrated anorexia-distress SC, bowel-digestive related SC and sleep disturbance related SC, and anorexia-distress SC should be considered as the priority SC given its multidimensional significance for patients. The last theme described the patient's positive attitudes, behaviours and barriers to coping with symptoms, namely "symptom self-management experience". CONCLUSION There are differences in the perception and interpretation of SCs in postoperative pancreatic cancer patients. Understanding the meaning of individual differences in the experience of symptoms can assist patients in the management of SCs. Medical staff should combine patient self-management strategies and evidence-based data to provide appropriate support at different stages to improve patient symptom management and quality of life.
Collapse
Affiliation(s)
- Changying Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Linglong Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Mingxia Chen
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
31
|
Frequency and burden of potentially treatable symptoms in glioma patients with stable disease. Heliyon 2023; 9:e13278. [PMID: 36798771 PMCID: PMC9925977 DOI: 10.1016/j.heliyon.2023.e13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Background & aims Glioma patients experience a multitude of symptoms that negatively affect their health-related quality of life. Symptoms vary greatly across disease phases, and the patients' stable phase might be particularly suitable for assessing and treating symptoms. Identifying symptoms and patients' needs is a first step toward improving patient care. In glioma patients with stable disease, we assessed the frequency and burden of patient-reported symptoms, examined how these symptoms co-occur, and also determined whether patients would consider treatment to ameliorate specific symptoms. Methods In this retrospective study, patients rated the frequency and burden of seventeen symptoms on a seven-point Likert scale and stated whether they would consider treatment for these symptoms. Correlations between frequency, burden, and considering treatment were evaluated with Kendall's Tau correlation coefficients. Based on partial correlations between symptom frequencies we visualized the symptoms as a network. Results Fifty-two glioma patients with stable disease were included (31 WHO grade II/III, 21 WHO grade IV). The top five symptoms were fatigue, memory problems, reduced physical fitness, concentration problems, and drowsiness. Fatigue had the highest median frequency (4.5, interquartile range 2.5). Over half of the patients experienced three or more symptoms simultaneously and associations between all symptoms were depicted as a network. Overall, 35% of patients would consider treatment for at least one symptom. The wish to undergo symptom treatment correlated only moderately with symptom frequency and burden (range of correlations 0.24-0.57 and 0.28-0.61, respectively). Conclusion Glioma patients with stable disease experience multiple symptoms with a consequently high symptom burden. Despite the high prevalence of symptoms, the inclination for symptom management interventions was relatively low. The most frequent and burdensome symptoms and the way they are interrelated could serve as a roadmap for future research on symptom management in these patients.
Collapse
|
32
|
Shin H, Dudley WN, Bhakta N, Horan MR, Wang Z, Bartlett TR, Srivastava D, Yasui Y, Baker JN, Robison LL, Ness KK, Krull KR, Hudson MM, Huang IC. Associations of Symptom Clusters and Health Outcomes in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study. J Clin Oncol 2023; 41:497-507. [PMID: 36166720 PMCID: PMC9870227 DOI: 10.1200/jco.22.00361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To identify symptom clusters among adult survivors of childhood cancers and test associations with health-related quality of life (HRQOL) and physical and neurocognitive performance. METHODS This cross-sectional study included 3,085 survivors (mean age at evaluation 31.9 ± 8.3 years; mean years from diagnosis 28.1 ± 9.1) participating in the St Jude Lifetime Cohort Study. Survivors self-reported the presence of 37 symptoms capturing 10 domains (cardiac, pulmonary, sensory, motor/movement, nausea, pain, fatigue, memory, anxiety, and depression). The Short Form-36's Physical/Mental Component Summaries assessed HRQOL; the Physical Performance Test evaluated physical performance; and neurocognitive batteries tested attention, processing/psychomotor speed, memory, and executive function. Latent class analysis identified subgroups of survivors experiencing different patterns of symptom burden (ie, symptom clusters). Multivariable regression models identified risk of cluster membership and tested associations with health outcomes. RESULTS Four symptom clusters were identified including cluster 1 (prevalence 52.4%; low physical, somatization, and psychologic domains), cluster 2 (16.1%; low physical, moderate somatic, and high psychologic domains), cluster 3 (17.6%; high physical, moderate somatic, and low psychologic domains), and cluster 4 (13.9%; high in all three domains). Compared with cluster 1, survivors in cluster 4 were more likely to have less than high school education (odds ratio [OR], 7.71; 95% CI, 4.46 to 13.31), no insurance (OR, 1.49; 95% CI, 1.04 to 2.13), and exposure to corticosteroids (OR, 1.76; 95% CI, 1.02 to 3.03); survivors in cluster 3 were more likely to have received platinum agents (OR, 2.22; 95% CI, 1.34 to 3.68) and brain radiation ≥ 30 Gy (OR, 3.99; 95% CI, 2.33 to 6.86). Survivors in cluster 4 reported the poorest Physical Component Summary/Mental Component Summary scores (31.0/26.7) and physical and neurocognitive performance versus survivors in the other clusters (P < .001). CONCLUSION Nearly 50% of survivors had moderate to high multisymptom burden, which was associated with sociodemographic, treatment factors, HRQOL, and functional outcomes.
Collapse
Affiliation(s)
- Hyewon Shin
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - William N. Dudley
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Madeline R. Horan
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Zhaoming Wang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | | | - Deokumar Srivastava
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Justin N. Baker
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
- Department of Psychology, St Jude Children's Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
33
|
Llamas-Ramos I, Alvarado-Omenat JJ, Rodrigo-Reguilón M, Llamas-Ramos R. Quality of Life and Side Effects Management in Cancer Treatment-A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1708. [PMID: 36767073 PMCID: PMC9914572 DOI: 10.3390/ijerph20031708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
Cancer disease is a world problem which is increasing in its prevalence. Oncology patients have a multitude of symptoms derived from the treatments and from the disease itself that affect their quality of life to a greater or lesser extent. The aim of this study has been to discover the physical and psychological symptoms related to chemotherapy treatment in Spanish cancer patients in order to improve their quality of life. Symptoms from the previous week were taken into account and the Memorial Symptom Assessment Scale was used to measure the frequency, severity and associated distress of 32 symptoms. A total of 246 chemotherapy patients at the University Day Hospital in Salamanca completed the scale once while receiving chemotherapy treatment. A 95% confidence interval was considered. The most prevalent symptoms were a lack of energy (76.4%), anxiety (66.7%) and a dry mouth (60.6%). Lung cancer was the most prevalent cancer in men (26%) and breast cancer was the most prevalent cancer in women (72%). There is no consensus on which is the most prevalent symptom in this population and more studies will need to be carried out to determine the best treatment protocols. Symptom's prevalence knowledge could improve the patients' care to prevent or avoid complications and to improve the cancer patients' quality of life.
Collapse
Affiliation(s)
- Inés Llamas-Ramos
- Faculty of Nursing and Physiotherapy, Universidad de Salamanca, C/Donantes de Sangre s/n, 37007 Salamanca, Spain
- University Hospital of Salamanca, Paseo de San Vicente, 182, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | | | | | - Rocío Llamas-Ramos
- Faculty of Nursing and Physiotherapy, Universidad de Salamanca, C/Donantes de Sangre s/n, 37007 Salamanca, Spain
| |
Collapse
|
34
|
Grayson SC, Patzak SA, Dziewulski G, Shen L, Dreisbach C, Lor M, Conway A, Koleck TA. Moving beyond Table 1: A critical review of the literature addressing social determinants of health in chronic condition symptom cluster research. Nurs Inq 2023; 30:e12519. [PMID: 36283980 PMCID: PMC10204618 DOI: 10.1111/nin.12519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 01/25/2023]
Abstract
Variability in the symptom experience in patients diagnosed with chronic conditions may be related to social determinants of health (SDoH). The purpose of this critical review was to (1) summarize the existing literature on SDoH and symptom clusters (i.e., multiple, co-occurring symptoms) in patients diagnosed with common chronic conditions, (2) evaluate current variables and measures used to represent SDoH, (3) identify gaps in the evidence base, and (4) provide recommendations for the incorporation of SDoH into future symptom cluster research. We identified 118 articles including information on SDoH in chronic condition symptom cluster research. Articles primarily focused on cancer populations. Few articles had the explicit purpose of investigating relationships between SDoH and symptom clusters, and the inclusion of SDoH was often limited to variables used to describe samples. Future studies should be designed to "move beyond Table 1" in their utilization of SDoH as variables and examine relationships between SDoH and symptom clusters. Attention should be paid to the appropriateness of measures being used to collect information on SDoH, and analysis methods that estimate causal connections between variables should be considered. Research regarding the relationship of SDoH with symptom clusters in patients with chronic conditions has the potential to reveal mechanisms of symptom disparities and guide changes to alleviate these disparities.
Collapse
Affiliation(s)
- Susan C. Grayson
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, Pennsylvania 15261
| | - Sofie A. Patzak
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, Pennsylvania 15261
| | - Gabriela Dziewulski
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, Pennsylvania 15261
| | - Lingxue Shen
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, Pennsylvania 15261
| | - Caitlin Dreisbach
- Data Science Institute, Columbia University, Northwest Corner, 550 W 120 Street #1401, New York, New York 10027
- School of Nursing, University of Rochester, 255 Crittenden Boulevard, Rochester, New York 14642
| | - Maichou Lor
- School of Nursing, University of Wisconsin-Madison, 701 Highland Avenue, Signe Skott Cooper Hall, Madison, Wisconsin 53705
| | - Alex Conway
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, Pennsylvania 15261
| | - Theresa A. Koleck
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, Pennsylvania 15261
| |
Collapse
|
35
|
Fei F, J Siegert R, Zhang X, Gao W, Koffman J. Symptom clusters, associated factors and health-related quality of life in patients with chronic obstructive pulmonary disease: A structural equation modelling analysis. J Clin Nurs 2023; 32:298-310. [PMID: 35098602 PMCID: PMC10078635 DOI: 10.1111/jocn.16234] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To identify symptom clusters and develop a symptom cluster model among people living with chronic obstructive pulmonary disease (COPD). BACKGROUND The examination of symptom clusters in COPD patients is an emerging field of scientific inquiry directed towards symptom management. However, no studies have modelled the relationships among symptom clusters, associated factors and health-related quality of life. DESIGN A cross-sectional design with convenience sampling following STROBE guidelines. METHODS Data were collected from 450 COPD participants in three university teaching hospitals. Participants were invited to complete a structured questionnaire comprised of a socio-demographic/clinical questionnaire, Integrated Palliative Care Outcome Scale and Clinical Respiratory Questionnaire. Exploratory factor analysis and confirmatory factor analysis were used to identify symptom clusters. Structural equation modelling was used to examine the proposed model. RESULTS The respiratory related symptom cluster, psychological symptom cluster and cough-insomnia related symptom cluster were identified. The final model demonstrated a good fit with the data. Gender, stage of disease and monthly income were significant factors associated with symptom clusters. Respiratory related and cough-insomnia related symptom clusters had a direct negative impact on health-related quality of life, while the psychological symptom cluster was found to have a direct and indirect negative effect on health-related quality of life. CONCLUSIONS Final COPD symptom cluster model should serve as a framework to guide intervention research targeting symptom clusters to improve health-related quality of life of people living with COPD. RELEVANCE TO CLINICAL PRACTICE Nurses should be especially attuned to identify those at most risk of facing a higher symptom burden in this case those who are female, have advanced stage COPD and/or lower income. During the clinical symptom assessment, nurses should pay attention to the close relationships among symptoms within a cluster to identify any 'trigger' symptom that could cause the development or exacerbation of other symptoms.
Collapse
Affiliation(s)
- Fei Fei
- Florence Nightingale Faculty of NursingMidwifery and Palliative CareCicely Saunders InstituteKing’s College LondonLondonUK
- School of Nursing and MidwiferyJiangsu College of NursingHuai'anJiangsuChina
| | - Richard J Siegert
- Faculty of Health and Environmental SciencesAuckland University of TechnologyAucklandNew Zealand
| | - Xiaohan Zhang
- School of Nursing and MidwiferyJiangsu College of NursingHuai'anJiangsuChina
| | - Wei Gao
- Florence Nightingale Faculty of NursingMidwifery and Palliative CareCicely Saunders InstituteKing’s College LondonLondonUK
| | - Jonathan Koffman
- Florence Nightingale Faculty of NursingMidwifery and Palliative CareCicely Saunders InstituteKing’s College LondonLondonUK
| |
Collapse
|
36
|
Miladinia M, Jahangiri M, Kennedy AB, Fagerström C, Tuvesson H, Safavi SS, Maniati M, Javaherforooshzadeh F, Karimpourian H. Determining massage dose-response to improve cancer-related symptom cluster of pain, fatigue, and sleep disturbance: A 7-arm randomized trial in palliative cancer care. Palliat Med 2023; 37:108-119. [PMID: 36226676 DOI: 10.1177/02692163221129158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The efficacy of various massage doses in palliative cancer care settings is still debated, and no specific protocol is available. AIM Evaluating response to various massage doses for symptom cluster of pain-fatigue-sleep. DESIGN A 7-arm randomized-controlled trial with weekly massage for 4 weeks depending on the prescribed dose (15-, 30-, or 60-min; 2× or 3×/week) and a 4-week follow-up. The intensities of pain, fatigue, and sleep disturbance were measured using a 0-10 scale at nine-timepoint; baseline, weekly during the intervention, and the follow-up period. Then, the mean scores of the three symptoms were calculated as the symptom cluster intensity at each timepoint. IRCT.ir IRCT20150302021307N5. SETTING/PARTICIPANTS Adults with cancer (n = 273) who reported all three symptoms at three oncology centers in Iran. RESULTS The odds of clinical improvement (at least 30% reduction in symptom cluster intensity from baseline) increased with dose-escalation significantly [(OR = 17.37; 95% CI = 3.87-77.90 for 60-min doses); (OR = 11.71; 95% CI = 2.60-52.69, for 30-min doses); (OR = 4.36; 95% CI = 0.94-20.32, for 15-min doses)]. The effect durability was significantly shorter at 15-min doses compared to 30- and 60-min doses. The odds of improvement for doses 3×/week was not significant compared to doses 2×/week (OR = 12.27 vs OR = 8.34); however, the effect durability for doses 3×/week was significantly higher. CONCLUSIONS The findings indicated that dose-escalation increases the efficacy of massage for the pain-fatigue-sleep symptom cluster. Although the 60-min doses were found to be more effective, the 30-min doses can be considered more practical because they are less costly and time-consuming. Our findings can be helpful to develop massage guidelines in palliative care settings. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT20150302021307N5.
Collapse
Affiliation(s)
- Mojtaba Miladinia
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nursing, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Jahangiri
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ann Blair Kennedy
- Department of Biomedical Sciences, University of South Carolina, School of Medicine Greenville, Greenville, SC, USA.,Department of Family Medicine, Prisma Health, Greenville, SC, USA
| | - Cecilia Fagerström
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.,Department of Research, Region Kalmar County, Kalmar, Sweden
| | - Hanna Tuvesson
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Shadi Sadat Safavi
- School of Healthcare & Social Practice, Unitec Institute of Technology, Auckland, New Zealand
| | - Mahmood Maniati
- School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Javaherforooshzadeh
- Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Karimpourian
- Department of Medical Oncology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
37
|
SEMİZ D, SAĞLAM AKSÜT R. Validity and Reliability of the Symptom-Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy. BEZMIALEM SCIENCE 2022. [DOI: 10.14235/bas.galenos.2022.74946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
38
|
Effendy C, Kristanti MS. Open and structured assessment in addressing hospitalized cancer-related problems: The perception of patients and nurses in Indonesia. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2148196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Christantie Effendy
- Department of Medical-Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Lotus Care, Wound and Palliative Homecare Center, Private Clinic, Yogyakarta, Indonesia
| | - Martina Sinta Kristanti
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
39
|
Salomon RE, Dobbins S, Harris C, Haeusslein L, Lin CX, Reeves K, Richoux S, Roussett G, Shin J, Dawson-Rose C. Antiracist symptom science: A call to action and path forward. Nurs Outlook 2022; 70:794-806. [PMID: 36400578 PMCID: PMC10916506 DOI: 10.1016/j.outlook.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022]
Abstract
Nurse scientists recognize the experience of racism as a driving force behind health. However, symptom science, a pillar of nursing, has rarely considered contributions of racism. Our objective is to describe findings within symptom science research related to racial disparities and/or experiences of racism and to promote antiracist symptom science within nursing research. In this manuscript, we use an antiracist lens to review a predominant symptom science theory and literature in three areas of symptom science research-oncology, mental health, and perinatal health. Finally, we make recommendations for increasing antiracist research in symptom science by altering (a) research questions, (b) recruitment methods, (c) study design, (d) data analysis, and (e) dissemination of findings. Traditionally, symptom science focuses on individual level factors rather than broader contexts driving symptom experience and management. We urge symptom science researchers to embrace antiracism by designing research with the specific intent of dismantling racism at multiple levels.
Collapse
Affiliation(s)
- Rebecca E Salomon
- The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Sarah Dobbins
- San Francisco Department of Public Health, San Francisco, California
| | | | | | - Chen-Xi Lin
- University of California, San Francisco, San Francisco, California
| | - Katie Reeves
- University of California, San Francisco, San Francisco, California
| | - Sarah Richoux
- University of California, San Francisco, San Francisco, California
| | - Greg Roussett
- University of California, San Francisco, San Francisco, California
| | - Joosun Shin
- University of California, San Francisco, San Francisco, California
| | | |
Collapse
|
40
|
Wu CJ, Chen YC, Bai LY, Chiou TJ, Lin KC, Wang YJ. Trajectories of symptom severity predicts quality of life change in newly diagnosis lymphoma survivors: An initial study. Eur J Cancer Care (Engl) 2022; 31:e13741. [PMID: 36254839 DOI: 10.1111/ecc.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to explore the subgroups of symptom severity and impact of their trajectories on quality of life in lymphoma survivors. METHODS Secondary data were analysed from a prospective study with four-time measures: before treatment (T1), during treatment (T2), treatment completion (T3) and 10 weeks after treatment (T4). Data were analysed using descriptive statistics, group-based trajectory model and generalised estimation equation. RESULTS Fifty nine of 61 participants completed three-time measure (mean age = 60.43 years, male-predominant). The changes in symptom severity over time were divided into two subgroups: slight-stable group (n = 54, 89%) and mild-fickle group (n = 7, 11%). Pain, tiredness and sleeping trouble were the predominant symptoms. The quality of life change in the slight-stable group was significantly better than that of the mild-fickle group (B = 13.35, SE = 3.53, p < 0.001). The overall quality of life at T2, T3 and T4 was better than it was at T1. CONCLUSION The different trajectories of symptom severity significantly influenced quality of life changes in lymphoma survivors. Healthcare providers must be aware that there is a group of lymphoma survivors with relatively severe symptoms when newly diagnosed, compared to the opposite. More attention must be paid to this group, in addition to providing in-time symptom management.
Collapse
Affiliation(s)
- Chih-Jung Wu
- School of Nursing, China Medical University, Taichung, Taiwan
| | - Yu-Chi Chen
- Department of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Yuan Bai
- Department of Hematology and Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Tzeon-Jye Chiou
- Department of Hematology and Oncology, Taipei Municipal Wanfang Hospital, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Jung Wang
- Department of Nursing, DaYeh University, Changhua, Taiwan
| |
Collapse
|
41
|
Symptom Management and Quality of Life of Breast Cancer Patients Using Acupuncture-Related Therapies and Herbal Medicine: A Scoping Review. Cancers (Basel) 2022; 14:cancers14194683. [PMID: 36230606 PMCID: PMC9564317 DOI: 10.3390/cancers14194683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary This is a scoping review of published literature on the usefulness of acupuncture-related therapies and herbal medicine in alleviating the side effects associated with breast cancer treatments. It is an important study given that the various treatment interventions for breast cancer, such as surgery, chemotherapy, radiotherapy, and hormone therapy, have unpleasant side effects that compromise the patient’s quality of life. The study revealed positive impact of some acupuncture-related therapies and herbal medicines in improving the symptoms and quality of life of patients with breast cancer. These findings will inform further studies on the economic impact of acupuncture and herbal medicines in the management of adverse events in patients on breast cancer treatment. Abstract The side effects associated with breast cancer treatments often reduce the patients’ quality of life. The effectiveness of acupuncture-related therapies and herbal medicine in managing the side effect is not fully understood. The study included clinical studies published in the 10 years since 2011 and analyzed the effectiveness of the therapies for managing side effects of anticancer treatment. The databases of MEDLINE via PubMed, CENTRAL, EMBASE, OASIS, and NSDL were searched. Thirty studies, including 13 (43.3%) randomized controlled trials (RCTs), 12 (40.0%) before-and-after studies, three (10.0%) case series, one (3.3%) case report, and one (3.3%) non-RCT, were included in this review. The main symptoms identified were aromatase inhibitors-induced arthralgia (AIA), lymphedema, and chemotherapy-induced peripheral neuropathy (CIPN). The types of acupuncture-related therapies applied included manual acupuncture, electro-acupuncture, moxibustion, and electro-moxibustion. In ten studies, eight herbal medications were administered. The Brief Pain Inventory-Short Form (BPI-SF) and Functional Assessment of Cancer Therapy-General (FACT-G) and -Breast (FACT-B) were frequently used to evaluate pain and QoL, respectively. Most studies suggested beneficial effects of acupuncture and herbal medicine on managing pain, daily function, and quality of life in patients going through AIA, CIPN, and/or lymphedema, with mild side effects. The scoping review implies the potential of CAM therapies as promising interventions for managing symptoms which otherwise lack alternative management options, and for improving the quality of life of breast cancer patients.
Collapse
|
42
|
Lin L, Zuo S, Wang Z. Nurse-guided non-pharmacological multi-component symptom cluster management intervention: A good attempt at exploring effective symptom cluster relief strategies for lung cancer. Asia Pac J Oncol Nurs 2022; 9:100150. [DOI: 10.1016/j.apjon.2022.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/02/2022] Open
|
43
|
Scroggins JK, Ledbetter LS, Jones-Hepler B, Brandon D, Reuter-Rice K. Postpartum symptom clusters in birthing individuals: A systematic review. J Clin Nurs 2022. [PMID: 35995761 DOI: 10.1111/jocn.16494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/13/2022] [Accepted: 08/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Birthing individuals experience various postpartum symptoms which have been associated with adverse health outcomes. Previous systematic reviews have focused on the examination of individual symptoms and their impact on health, which have limited our understanding of postpartum symptom clusters. OBJECTIVE To examine the compositions of symptom clusters, analytic methodologies and predictors of symptom clusters in birthing individuals up to 1 year postpartum. DESIGN Systematic review. METHODS This systematic review was reported following the PRISMA. Five databases were searched: PubMed, Embase, CINAHL Complete, PsycINFO and Scopus. Two reviewers performed title and abstract and full-text screening independently. Standard Quality Assessment Criteria were used to assess the articles' qualities. Key information was extracted into evidence table, which was checked for accuracy and completeness. A narrative synthesis was conducted. RESULTS A total of 30 articles were included. Studies were conducted in 16 countries, mostly in Europe (n = 9) and North America (n = 7). The majority were quantitative (n = 27) and cross-sectional (n = 27). Factor analysis was the most frequently used analytic methodology (n = 21). All three qualitative studies used grounded theory. Taking into consideration the variations among the studies, stress (n = 15, infant or partner-related and from other sources), depression (n = 12), somatic (n = 12) and anxiety clusters (n = 10) were most frequently identified. Symptom cluster predictors were examined in less than half of the included studies (n = 13). Among these, most were focused on how individual postpartum symptoms influence symptom clusters. CONCLUSIONS Stress, depression, somatic and anxiety clusters are the most frequently identified postpartum symptom clusters. Future studies should examine the consistency, stability and clinical meaningfulness of these four symptom clusters. RELEVANCE TO CLINICAL PRACTICE The identification and management of the four symptom clusters should be of particular interest to clinicians and researchers. NO PATIENT OR PUBLIC CONTRIBUTION This systematic review did not directly involve patient or public contribution to the manuscript.
Collapse
Affiliation(s)
| | - Leila S Ledbetter
- Duke University Medical Center Library & Archives, Durham, North Carolina, USA
| | | | - Debra Brandon
- Duke University School of Nursing, Durham, North Carolina, USA.,Duke University School of Medicine, Durham, North Carolina, USA
| | - Karin Reuter-Rice
- Duke University School of Nursing, Durham, North Carolina, USA.,Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
44
|
Haryani, Hsu YY, Wang ST. Symptom clusters change over time among patients with gynecological cancer receiving chemotherapy. Eur J Oncol Nurs 2022; 60:102193. [PMID: 36030751 DOI: 10.1016/j.ejon.2022.102193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE This study aimed to explore symptom clusters at different time points among patients with gynecological cancer undergoing chemotherapy. METHODS A longitudinal design was used to explore the patterns of symptom clusters four times: during prechemotherapy (T0), first (T1), second (T2), and third (T3) cycles of chemotherapy. The Memorial Symptom Assessment Scale was used to assess the dimension of symptoms. The study was conducted in Indonesia. Exploratory factor analysis was used to analyze the structures of symptom clusters across time. RESULTS A total of 120 subjects provided baseline data, and 82 were retained at T3. Before chemotherapy, the most prevalent symptoms were pain and difficulty in sleeping. However, after starting chemotherapy, the patients suffered from chemotherapy-related side effects, including nausea, change in taste, lack of appetite, hair loss, fatigue, and feeling of "I don't look like myself." Six symptom clusters were identified in patients with gynecological cancer across four time points during chemotherapy: pain-related, nutritional, emotional, hormonal-related, fatigue-related, and body-image symptom clusters. Nutrition and emotion symptom clusters occurred consistently from T0 to T3, fatigue-related clusters appeared after chemotherapy at T1 and T2, and body-image symptom clusters emerged at late T2 and T3. CONCLUSION The structures of symptom clusters in this study were dynamic and various. The nutrition and emotional-related symptoms constituted a cluster during chemotherapy. Oncology nurses should provide physical and psychosocial interventions to relieve these symptoms in patients with gynecological cancer undergoing chemotherapy.
Collapse
Affiliation(s)
- Haryani
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Yu-Yun Hsu
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan.
| | - Shan-Tair Wang
- Professor & Deputy Superintendent Ditmanson Medical Foundation, Chiayi Christian Hospital
| |
Collapse
|
45
|
Application of Nursing Intervention Plan Based on Symptom Management Theory among Breast Cancer Patients. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:3816768. [PMID: 36051927 PMCID: PMC9410828 DOI: 10.1155/2022/3816768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
In order to explore the application effect of nursing intervention based on symptom management theory in breast cancer patients, a total of 120 breast cancer patients who were hospitalized in the Thyroid and Breast Surgery Department of Zhejiang Xiaoshan Hospital from July 2018 to July 2021 were selected as the research subjects. Patients from the control group received routine nursing, while patients from the intervention group underwent nursing interventions based on symptom management theory. Before and after the intervention, symptom distress, Herth Hope Index, quality of life, self-rating anxiety scale (SAS), self-rating depression scale (SDS), visual analogue score (VAS), and Pittsburgh sleep quality index (PSQI) were evaluated in two groups. The results showed that the symptom severity score and the symptom distress score, SAS scores, SDS scores, VAS scores, and PSQI scores in the intervention group were significantly lower than those in the control group, while the Herth Hope Index scores and FACT-B scores in the intervention group were obviously higher than those in the control group (all P < 0.05) after intervention. In conclusion, nursing interventions based on symptom management theory could decrease symptom distress among breast cancer patients, increase their hope levels, improve their life quality, relieve the negative emotions, enhance the sleep quality, and reduce their pain. It is worthy of clinical application.
Collapse
|
46
|
Wallström S, Sutherland JM, Kopec JA, Anis AH, Sawatzky R. Distinguishing symptom patterns in adults newly diagnosed with cancer: a latent class analysis. J Pain Symptom Manage 2022; 64:146-155. [PMID: 35460831 DOI: 10.1016/j.jpainsymman.2022.04.172] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Socio-demographic differences, including place of residence, socio-economic status, ethnicity, and gender, have been associated with various inequities in cancer care outcomes. OBJECTIVES The aims were to distinguish subgroups of patients with different symptom patterns at the time of the initial oncology visit and determine which clinical and socio-demographic variables are associated the different symptom patterns. METHOD Responses to the Edmonton Symptom Assessment Scale- revised and clinical and socio-demographic variables were obtained via the Ontario Cancer Registry and linked health data files. Latent class analyses were conducted to identify and compare the subgroups. RESULTS The cohort (n = 216,110) with a mean age of 64.5 years consisted of 54.1% women. The analyses identified six latent classes (proportions ranging from 0.09 to 0.31) with distinct symptom patterns, including: 1) many severe symptoms, 2) many less severe symptoms, 3) predominantly mild symptoms, 4) severe psychosocial symptoms, 5) severe somatic symptoms, 6) few symptoms. The subgroups were associated not only with clinical differences (diagnoses and functional status), but also with various socio-demographic (age, sex) and community characteristics (neighborhood income, proportion of foreign born, rurality). CONCLUSION The results indicated that there were substantial differences in symptom patterns at the time of the initial oncology visit, which were associated with both clinical diagnoses and socio-demographic differences. These results point to the importance of taking the social situation of patients into account, and not just diagnosis, to better understand differences in symptom patterns of people living with cancer.
Collapse
Affiliation(s)
- Sara Wallström
- Institute of Health and Care Sciences (S.W., R.S.), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center for Person-Centered Care (GPCC) (S.W.), University of Gothenburg, Gothenburg, Sweden; Forensic Psychiatric Clinic (S.W.), Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jason M Sutherland
- Center for Health Services and Policy Research (J.M.S.), School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health (J.M.S., J.A.K., A.H.A.), University of British Columbia, Vancouver, BC, Canada; Center for Health Evaluation and Outcome Sciences (J.M.S., R.S.), Vancouver, BC, Canada
| | - Jacek A Kopec
- Arthritis Research Canada (J.A.K.), Vancouver, BC, Canada; School of Population and Public Health (J.M.S., J.A.K., A.H.A.), University of British Columbia, Vancouver, BC, Canada
| | - Aslam H Anis
- School of Population and Public Health (J.M.S., J.A.K., A.H.A.), University of British Columbia, Vancouver, BC, Canada; Center for Health Evaluation and Outcome Sciences (J.M.S., R.S.), Vancouver, BC, Canada
| | - Richard Sawatzky
- Institute of Health and Care Sciences (S.W., R.S.), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center for Health Evaluation and Outcome Sciences (J.M.S., R.S.), Vancouver, BC, Canada; School of Nursing (R.S.), Trinity Western University, Langley, BC, Canada.
| |
Collapse
|
47
|
Salvetti MDG, Sanches MB. Symptom cluster: management and advanced practices in oncology nursing. Rev Esc Enferm USP 2022; 56:e20210452. [PMID: 35766922 DOI: 10.1590/1980-220x-reeusp-2021-0452en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/12/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To present the definition of "symptom cluster" in cancer patients and to reflect on the theory, assessment, outcomes, and interventions for symptom management, based on the perspective of advanced practices in oncology nursing. METHOD Theoretical-reflective study that presents and discusses possibilities for managing "symptom clusters" through advanced practices in oncology nursing. RESULTS The term "symptom cluster" can be defined as a set of two or more related symptoms. The theoretical concepts and models that can help in its understanding are: Theory of Unpleasant Symptoms, Theory of Symptom Management, concept of self-efficacy and Theory of symptom self-management. Advanced practice nurses have the skills to manage "symptom clusters," optimizing outcomes and positively influencing the quality of life of cancer patients. CONCLUSION Advanced practice nurses have the essential characteristics to design, to implement and to evaluate intervention protocols aimed at the management of "symptom clusters" in cancer patients.
Collapse
Affiliation(s)
- Marina de Góes Salvetti
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil
| | - Mariana Bucci Sanches
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil.,Hospital Sírio Libanês, São Paulo, SP, Brazil
| |
Collapse
|
48
|
Bai J, Withycombe J, Eldridge RC. Metabolic Pathways Associated With Psychoneurological Symptoms in Children With Cancer Receiving Chemotherapy. Biol Res Nurs 2022; 24:281-293. [PMID: 35285272 PMCID: PMC9343884 DOI: 10.1177/10998004211069619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
CONTEXT Children with cancer undergoing chemotherapy experience a cluster of psychoneurological symptoms (PNS), including pain, fatigue, anxiety, and depressive symptoms. Metabolomics is promising to differentiate metabolic pathways associated with the PNS cluster. OBJECTIVES Identify metabolic pathways associated with the PNS cluster in children with cancer before and after chemotherapy. METHODS Pain, fatigue, anxiety, and depressive symptoms were assessed using the Pediatric PROMIS scales. T-scores were computed and divided dichotomously by a cutoff point of 50; the PNS cluster was a sum of the four symptoms ranging from 0 (all T-scores <50) to 4 (all T-scores ≥50). Serum metabolites were processed using liquid chromatography mass-spectrometry untargeted metabolomics approach. Linear regression models examined metabolites associated with the PNS cluster. Metabolic pathway enrichment analysis was performed. RESULTS Participant demographics (n = 40) were 55% female, 60% white, 62.5% aged 13-19 years, and 62.5% diagnoses of Hodgkin's lymphoma and B-cell acute lymphocytic leukemia. Among 9276 unique metabolic features, 454 were associated with pain, 281 with fatigue, 596 with anxiety, 551 with depressive symptoms, and 300 with the PNS cluster across one chemotherapy cycle. Fatty acids pathways were associated with pain: de novo fatty acid biosynthesis (p < .001), fatty acid metabolism (p = .001), fatty acid activation (p = .004), and omega-3 fatty acid metabolism (p = .009). Tryptophan amino acid pathway was associated with fatigue (p < .001), anxiety (p = .015), and the PNS cluster (p = .037). Carnitine shuttle was associated with the PNS cluster (p = .015). CONCLUSION Fatty acids and amino acids pathways were associated with PNS in children undergoing chemotherapy. These findings require further investigation in a larger sample.
Collapse
Affiliation(s)
- Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | | | - Ronald C. Eldridge
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| |
Collapse
|
49
|
Varying severities of symptoms underline the relevance of personalized follow-up care in breast cancer survivors: latent class cluster analyses in a cross-sectional cohort. Support Care Cancer 2022; 30:7873-7883. [PMID: 35727375 DOI: 10.1007/s00520-022-07229-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/13/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Insights into the severity of co-existing symptoms can help in identifying breast cancer survivors in need of symptom management. We aimed to identify subgroups of breast cancer survivors based on patterns of symptom severity, and characteristics associated with these subgroups. METHODS We selected surgically treated stage I-III breast cancer survivors 1-5 years post-diagnosis from the Netherlands Cancer Registry (N = 876). We assessed experienced severity of fatigue, nausea, pain, dyspnea, insomnia, appetite, constipation, diarrhea, and emotional and cognitive symptoms through the EORTC-QLQ-C30 Quality of Life Questionnaire on a scale of 0-100. We determined subgroups of survivors using latent class cluster analyses (LCA) based on severity of co-existing symptoms and compared their mean severity to the age-matched female reference population to interpret clinical relevance. We assessed subgroup characteristics by multinomial logistic regression analyses. RESULTS From 404 respondents (46%), three subgroups of survivors with distinct symptom severity were identified: low severity (n = 116, 28.7%), intermediate severity (n = 224, 55.4%), and high severity (n = 59, 14.6%). The low subgroup reported lower symptom severity than the general population; the intermediate subgroup reported a similar symptom severity, although scores for fatigue, insomnia, and cognitive symptoms were worse (small-medium clinical relevance). The high subgroup had worse symptom severity (medium-large clinical relevance). Compared to the intermediate subgroup, one (RRR: 2.75; CI: 1.22-6.19; p = 0.015) or more (RRR: 9.19; CI: 3.70-22.8; p = < 0.001) comorbidities were significantly associated with the high subgroup. We found no associated treatment characteristics. CONCLUSION We identified distinct subgroups of breast cancer survivors based on symptom severity, underlining the relevance of further exploring personalized follow-up strategies.
Collapse
|
50
|
Chen F, Leng Y, Ni J, Niu T, Zhang L, Li J, Zheng Y. Symptom clusters and quality of life in ambulatory patients with multiple myeloma. Support Care Cancer 2022; 30:4961-4970. [PMID: 35182229 DOI: 10.1007/s00520-022-06896-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 02/02/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of this study was to investigate symptom clusters and associated clinical factors in ambulatory multiple myeloma patients undergoing medication therapy. We also aimed to determine the correlations between symptom clusters and patient quality of life. METHODS A total of 174 multiple myeloma patients hospitalized in the haematology day unit were included in this study. A cross-sectional survey was conducted to examine symptoms and quality of life. Symptoms were assessed by the Chinese version of the Condensed Memorial Symptom Assessment Scale. Quality of life was measured with the Functional Assessment of Cancer Therapy-General. Principal component analysis was used to identify symptom clusters. Independent-samples t tests and chi-square tests were used for comparisons between groups. Spearman's rank correlation analysis was used to identify correlations. RESULTS We identified three symptom clusters in multiple myeloma patients: psychological; pain, dry mouth, and difficulty sleeping; and fatigue symptom cluster. For each symptom cluster, the patients could be categorized into a severe-symptom group or a mild-symptom group based on the distress of symptoms. The patients in each group exhibited differential demographic and clinical features. Symptom cluster distress was adversely correlated with patients' quality of life. CONCLUSIONS Ambulatory multiple myeloma patients undergoing anticancer medication therapy experience multiple symptoms, which can be categorized into three symptom clusters. For each symptom cluster, level of distress was associated with patients' demographic and clinical characteristics. The presence and level of distress of these symptom clusters have adverse impacts on patients' quality of life.
Collapse
Affiliation(s)
- Fengjiao Chen
- Department of Hematology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China
| | - Yamei Leng
- Department of Hematology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China
| | - Jingyao Ni
- Department of Hematology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China
| | - Ting Niu
- Department of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China
| | - Li Zhang
- Department of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China
| | - Jiping Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China.
| | - Yuhuan Zheng
- Department of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, Chengdu, 610041, China.
| |
Collapse
|