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Yang X, Bai J, Zhang J, Wang Y, Zhao H, Zhu X. Symptom clusters and their impacts on the quality of life of patients with lung cancer receiving immunotherapy: A cross-sectional study. J Clin Nurs 2024. [PMID: 38886988 DOI: 10.1111/jocn.17321] [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: 01/19/2024] [Revised: 03/22/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
AIM The objective of this study was to identify symptom clusters in lung cancer patients receiving immunotherapy and explore their impact on the quality of life of patients. BACKGROUND Immunotherapy is widely used in lung cancer; however, there is little understanding of symptom clusters and their impacts on the quality of life of this population. DESIGN Cross-sectional study. METHODS The survey contained the Memorial Symptom Assessment Scale (MSAS), Quality of Life Questionnaire-Lung Cancer 43 and a self-designed General Information Evaluation Form. Symptom clusters were identified using exploratory factor analysis (EFA) based on the symptom scores. Spearman correlation analysis was performed to evaluate the associations between each symptom cluster and the patients' quality of life. Multiple linear regression analysis was employed to examine the impact of the symptom clusters on quality of life. This study adhered to the STROBE guidelines. RESULTS In total, 240 participants completed the survey. Five symptom clusters were identified and named according to their characteristics: emotional-related symptom cluster, lung cancer-related symptom cluster, physical symptom cluster, skin symptom cluster and neural symptom cluster. All symptom clusters, except for the neural symptom cluster, had a significantly detrimental impact on patient quality of life. CONCLUSION Lung cancer patients undergoing immunotherapy experience a range of symptoms, which can be categorized into five clusters. These symptom clusters have a negative impact on patients' quality of life. Future research should focus on developing interventions for each symptom cluster and their influencing factors. PATIENT OR PUBLIC CONTRIBUTION In the data collection phase, lung cancer patients undergoing immunotherapy were recruited to participate in the survey.
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Affiliation(s)
- Xuying Yang
- Zhejiang Chinese Medical University, Hangzhou, China
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingcui Bai
- Department of Respiratory and Critical Care Medicine, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinhuang Zhang
- Shanxi Traditional Chinese Medical Hospital, Taiyuan, China
| | - Yanli Wang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huanping Zhao
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuehua Zhu
- Zhejiang Chinese Medical University, Hangzhou, China
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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.
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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.
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Luo Y, Mao D, Zhang L, Yang Z, Miao J, Zhang L. Identification of symptom clusters and sentinel symptoms during the first cycle of chemotherapy in patients with lung cancer. Support Care Cancer 2024; 32:385. [PMID: 38801450 PMCID: PMC11130015 DOI: 10.1007/s00520-024-08600-5] [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: 01/19/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE To identify symptom clusters (SCs) in patients with lung cancer who are undergoing initial chemotherapy and to identify the sentinel symptoms of each SC. METHODS A convenience sampling method was used to recruit patients with lung cancer who were undergoing their initial chemotherapy treatment. Patient information was collected using the General Demographic Questionnaire, MD Anderson Symptom Inventory (including the lung cancer module) and a schedule documenting the initial occurrence of symptoms. The Walktrap algorithm was employed to identify SCs, while sentinel symptoms within each SC were identified using the Apriori algorithm in conjunction with the initial occurrence time of symptoms. RESULTS A total of 169 patients with lung cancer participated in this study, and four SCs were identified: the psychological SC (difficulty remembering, sadness, dry mouth, numbness or tingling, and distress), somatic SC (pain, fatigue, sleep disturbance, and drowsiness), respiratory SC (coughing, expectoration, chest tightness, and shortness of breath), and digestive SC (nausea, poor appetite, constipation, vomiting, and weight loss). Sadness, fatigue, and coughing were identified as sentinel symptoms of the psychological, somatic, and respiratory SCs, respectively. However, no sentinel symptom was identified for the digestive SC. CONCLUSION Patients with lung cancer who are undergoing chemotherapy encounter a spectrum of symptoms, often presenting as SCs. The sentinel symptom of each SC emerges earlier than the other symptoms and is characterized by its sensitivity, significance, and driving force. It serves as a vital indicator of the SC and assumes a sentry role. Targeting sentinel symptoms might be a promising strategy for determining the optimal timing of interventions and for mitigating or decelerating the progression of the other symptoms within the SC.
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Affiliation(s)
- Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Dongmei Mao
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Le Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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Liu C, Liu T, Fang J, Liu X, Du C, Luo Q, Song L, Liu G, Li W, Li W, Geng L. Identifying symptom clusters and temporal interconnections in patients with lung tumors after CT-guided microwave ablation: A network analysis. Support Care Cancer 2024; 32:377. [PMID: 38780815 DOI: 10.1007/s00520-024-08560-w] [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: 11/28/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE To explore symptom clusters and interrelationships using a network analysis approach among symptoms in patients with lung tumors who underwent computed tomography (CT)-guided microwave ablation (MWA). METHODS A longitudinal study was conducted, and 196 lung tumor patients undergoing MWA were recruited and were measured at 24 h, 48 h, and 72 h after MWA. The Chinese version of the MD Anderson Symptom Inventory and the Revised Lung Cancer Module were used to evaluate symptoms. Network analyses were performed to explore the symptom clusters and interrelationships among symptoms. RESULTS Four stable symptom communities were identified within the networks. Distress, weight loss, and chest tightness were the central symptoms. Distress, and weight loss were also the most key bridge symptoms, followed by cough. Three symptom networks were temporally stable in terms of symptom centrality, global connectivity, and network structure. CONCLUSION Our findings identified the central symptoms, bridge symptoms, and the stability of symptom networks of patients with lung tumors after MWA. These network results will have important implications for future targeted symptom management intervention development. Future research should focus on developing precise interventions for targeting central symptoms and bridge symptoms to promote patients' health.
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Affiliation(s)
- Chunqin Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
- School of Medicine, Jinggangshan University, Ji'an, Jiangxi, China
| | - Tianchi Liu
- Department of Out-Patient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jia Fang
- Department of Nursing, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Xiaohua Liu
- Department of Out-Patient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chunling Du
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qin Luo
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Liqin Song
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Guangxin Liu
- School of Nursing, Shandong First Medical University, Tai'an, Shandong, China
| | - Wenjuan Li
- Department of Out-Patient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Weifeng Li
- Department of Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
| | - Li Geng
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Teng L, Zhou Z, Yang Y, Sun J, Dong Y, Zhu M, Wang T. Identifying central symptom clusters and correlates in patients with lung cancer post-chemotherapy: A network analysis. Asia Pac J Oncol Nurs 2024; 11:100383. [PMID: 38495643 PMCID: PMC10940888 DOI: 10.1016/j.apjon.2024.100383] [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: 10/24/2023] [Accepted: 01/17/2024] [Indexed: 03/19/2024] Open
Abstract
Objective This study aims to investigate the network structures of symptoms and symptom clusters in patients with lung cancer post-chemotherapy, with a focus on identifying the central symptom cluster. Understanding the central cluster is crucial for targeted and effective symptom management. Methods Symptom occurrence and severity were assessed using the Memorial Symptom Assessment Scale (MSAS). Principal component analysis (PCA) was employed to explore symptom clusters, while network analysis unveiled the network structure and pinpointed the central symptom cluster. Results The study included 512 patients with lung cancer. Four distinct symptom clusters emerged: sickness behavior, psychological, lung cancer-specific, and epithelial. The sickness behavior symptom cluster was identified as the central symptom cluster. Conclusions This research designates the sickness behavior symptom cluster as central in post-chemotherapy patients with lung cancer, offering valuable insights for clinical nurses in devising more effective symptom management strategies. Trial registration ChiCTR2300070944 (Chinese Clinical Trial Register).
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Affiliation(s)
- Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Zhou Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yiting Yang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jun Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yajun Dong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Teng Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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Li Y, Wang Q, Liu C, Hu X. Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102465. [PMID: 37956567 DOI: 10.1016/j.ejon.2023.102465] [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: 08/07/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning. METHOD A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis. RESULTS Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (β = -0.60, P = 0.02) and fatigue-related symptom cluster (β = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (β = -1.68, P < 0.01), role (β = -1.63, P < 0.01) and cognitive functioning (β = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (β = -1.26, P < 0.01); and the psychoneurological (β = -0.81, P < 0.01) and gastrointestinal symptom cluster (β = -0.60, P = 0.05) predicted social functioning. CONCLUSIONS Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.
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Affiliation(s)
- Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Qi Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Chunhua Liu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Chengdu, Sichuan, PR China.
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Ju X, Bai J, She Y, Zheng R, Xu X, Wang W, Hong J. Symptom cluster trajectories and sentinel symptoms during the first cycle of chemotherapy in patients with lung cancer. Eur J Oncol Nurs 2023; 63:102282. [PMID: 36889243 DOI: 10.1016/j.ejon.2023.102282] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To investigate symptom severity, symptom cluster trajectories and sentinel symptoms during chemotherapy cycle 1 in patients with lung cancer. METHODS Patients with lung cancer were recruited to complete the MD Anderson Symptom Inventory (MDASI) and First Appearance of Symptoms Time Sheet daily during the first week of chemotherapy cycle 1. Latent class growth analysis was performed to examine symptom cluster trajectories. The Apriori algorithm combined with the time of the first appearance of symptoms after chemotherapy was used to determine the sentinel symptoms of each symptom cluster. RESULTS A total of 175 lung cancer patients participated in the study. Five symptom clusters were identified: class 1 (difficulty remembering-numbness-hemoptysis-weight loss), class 2 (cough-expectoration-chest tightness-shortness of breath), class 3 (nausea-sleep disturbance-drowsiness-constipation), class 4 (pain-distress-dry mouth-sadness-vomiting), class 5 (fatigue-lack of appetite). Sentinel symptoms were found to be cough (class 2) and fatigue (class 5), while none were found for other symptom clusters. CONCLUSION The trajectories of five symptom clusters were observed during the first week of chemotherapy cycle 1 and the sentinel symptoms of each cluster were explored. The study has important significance for the effective management of symptoms and the quality of nursing care for patients. At the same time, alleviating sentinel symptoms may reduce the severity of the whole symptom cluster, reducing medical resources and improving quality of life for lung cancer patients.
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Affiliation(s)
- Xiaodi Ju
- School of Nursing, Anhui Medical University, PR China.
| | - Jiayuan Bai
- School of Nursing, Anhui Medical University, PR China.
| | - Yiwei She
- School of Nursing, Anhui Medical University, PR China.
| | - Rong Zheng
- School of Nursing, Anhui Medical University, PR China.
| | - Xiuzhi Xu
- School of Nursing, Anhui Medical University, PR China.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, PR China.
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Wang Y, Xie Z, Liu Y, Wang J, Liu Z, Li S. Symptom clusters and impact on quality of life in esophageal cancer patients. Health Qual Life Outcomes 2022; 20:168. [PMID: 36564827 PMCID: PMC9783739 DOI: 10.1186/s12955-022-02084-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 12/16/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Esophageal cancer patients can experience co-occurring, related symptoms labeled symptom clusters. This study aimed to identify symptom clusters and explore which SCs independently affect the quality of life (QoL) among esophageal cancer patients. METHODS This cross-sectional study was performed in Shenyang, China, from February 2021 to February 2022. Finally, 118 esophageal cancer patients effectively completed the survey. Questionnaires' information included the Functional Assessment of Cancer Therapy-General (FACT-G), the MD Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI), the Multidimensions Scale of Perceived Social Support, and demographic and clinical characteristics. Exploratory factor analysis with principal axis factoring was used to identify symptom clusters, and multiple regression analysis was employed to analyze the influencing factors of QoL. RESULTS The mean score of FACT-G was 69.88 (SD = 17.85) among 118 esophageal cancer patients. Four symptom clusters were identified: psychological-somatic, dysphagia, fatigue-pain, and gastrointestinal symptom clusters. Results of regression analysis indicated a significant impact on QoL for chemotherapy (β = 0.140, P < 0.045), psychological-somatic symptom cluster (β = - 0.329, P = 0.013), and social support (β = 0.409, P < 0.001) after adjusting demographic and clinical characteristics. The linear combination explained 47.8% of the variance in QoL. CONCLUSIONS There is a critical need to emphasize the importance of psychological-somatic symptoms clusters management programs and increasing social support to improve QoL in esophageal cancer patients.
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Affiliation(s)
- Yanli Wang
- grid.412636.40000 0004 1757 9485Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Zhongfei Xie
- grid.412636.40000 0004 1757 9485Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Yuxia Liu
- grid.412636.40000 0004 1757 9485Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Jianing Wang
- grid.412636.40000 0004 1757 9485Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Zhijun Liu
- grid.412636.40000 0004 1757 9485Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Sihan Li
- grid.412636.40000 0004 1757 9485Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, Liaoning Province China
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An Investigation of Symptom Clusters and Sentinel Symptoms During the First 2 Cycles of Postoperative Chemotherapy in Patients With Lung Cancer. Cancer Nurs 2022; 45:488-496. [PMID: 35089876 DOI: 10.1097/ncc.0000000000001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lung cancer has the highest incidence and mortality of all cancers in China. Patients after a lobectomy experience serious physical and psychological symptoms during chemotherapy. Studies are lacking about symptom clusters (SCs) and sentinel symptoms during the postoperative chemotherapy period in lung cancer patients. OBJECTIVE The aim of this study was to explore SCs and sentinel symptoms during cycles 1 and 2 of postoperative chemotherapy in patients with lung cancer. METHODS Using a longitudinal study design, patients in treatment for lung cancer were measured at 2 separate points following a lobectomy: chemotherapy cycle 1 and chemotherapy cycle 2. The MD Anderson Symptom Inventory lung cancer-specific module and First Appearance of Symptoms Time Sheet were completed. RESULTS A total of 180 postoperative patients with lung cancer participated in the study. Four SCs were identified at chemotherapy cycle 1: gastrointestinal SC, respiratory tract SC, psychological SC, and somatic SC. The sentinel symptoms were nausea, cough, sadness, and fatigue. At chemotherapy cycle 2, similar SCs were identified, with the exception of merging the psychological SC and somatic SC, resulting in 3 clusters: gastrointestinal SC, respiratory tract SC, and psychological-somatic SC. The sentinel symptoms were nausea, cough, and fatigue. CONCLUSIONS Symptom clusters and sentinel symptoms were stable during the first 2 cycles of postoperative chemotherapy in patients with lung cancer. IMPLICATIONS FOR PRACTICE The understanding of SCs and sentinel symptoms could be beneficial to assess and manage both in postoperative patients with lung cancer during chemotherapy. Nurses should pay close attention to sentinel symptoms and develop effective interventions.
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Zhang G, Weng H, Li Y, Li P, Gong Y, Chen J, Wei L, Zeng L, Zeng Y, Cheng AS. Symptom clusters and their predictors in patients with lung cancer and treated with programmed cell death protein 1 immunotherapy. Asia Pac J Oncol Nurs 2022; 9:100103. [PMID: 35935261 PMCID: PMC9345784 DOI: 10.1016/j.apjon.2022.100103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
Objective The aims of this study were to examine the symptom severity and interference among patients with lung cancer treated with PD-1 immunotherapy, explore whether those symptoms were clustered together, and identify factors associated with symptom clusters. Methods A cross-sectional study was conducted. Data were collected by demographic and clinical characteristic questionnaires and the M.D. Anderson Symptom Inventory Lung Cancer Module. Symptom clusters were identified using exploratory factor analysis, and stepwise linear regression was applied to analyze the factors affecting the symptom clusters. Results A total of 148 patients with lung cancer treated with PD-1 immunotherapy participated in this study. The overall symptom burdens of these patients were mainly at a mild level. The patient symptom clusters identified in this study were a general cluster, a treatment-related cluster, a pulmonary cluster, a gastrointestinal cluster, and a neural cluster. The patients’ Karnofsky performance status (KPS) score (β = −2.758, P < 0.001) and having a history of chemotherapy (β = 4.384, P = 0.001) were significant predictors of the general cluster. Their KPS scores (β = −1.202, P < 0.001) and having a history of chemotherapy (β = −1.957, P = 0.001) were significant predictors of the pulmonary cluster. Their monthly income (β = −0.316, P = 0.030) and KPS scores (β = −0.357, P = 0.045) were significant predictors of the gastrointestinal cluster. Having a history of chemotherapy (β = 1.868, P < 0.001) was the predictor of the neural cluster. Conclusions The symptom burdens of patients with lung cancer and treated with PD-1 immunotherapy were at a mild level and appeared to be clustered. In addition, because the symptoms that comprise a cluster are interrelated, the diagnosis and management of each symptom in a cluster should not be performed in isolation, and each symptom in a cluster should be treated either simultaneously or in an orderly manner.
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Affiliation(s)
- Guolong Zhang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huiwen Weng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yinghong Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pingdong Li
- Department of Nursing, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yucui Gong
- Department of Nursing, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jieya Chen
- Department of Nursing, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lin Wei
- Department of Nursing, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Linghui Zeng
- School of Medicine, Zhejiang University City College, Hangzhou, China
| | - Yingchun Zeng
- School of Medicine, Zhejiang University City College, Hangzhou, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Lee HJ, Park SK. Factors Related to the Caregiving Burden on Families of Korean Patients With Lung Cancer. Clin Nurs Res 2022; 31:1124-1135. [PMID: 35575283 DOI: 10.1177/10547738221098150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purposes of this study were to describe caregiver burden on families of patients with lung cancer and to examine its associated factors, including patient symptoms and symptom clusters. In this cross-sectional study, 120 patient-caregiver dyads were recruited from an outpatient clinic in a tertiary care hospital. Patient symptoms and caregiver burden were measured with structured questionnaire. Descriptive and inferential statistics were used to analyze data. Three patient symptom clusters were identified. Hierarchical regression showed that a patient's smoking history; caregiver age, education, health status, depression, social support, monthly family income, relationship with patient, and time spent on nursing each day; and presence of another caregiver explained 41.4% of the total variance in caregiver burden. When patient symptom clusters were added to regression model, change in total variance in caregiver burden was significant. To reduce their burden, caregivers should be taught how cancer progresses and its major symptoms after chemotherapy.
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Zhang L, Wang J, Chen T, Tian M, Zhou Q, Ren J. Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions. Front Psychiatry 2021; 12:807974. [PMID: 35173639 PMCID: PMC8841507 DOI: 10.3389/fpsyt.2021.807974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/23/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Although studies shows that symptom clusters and illness perceptions are negatively associated with quality of life (QoL), it is unclear how these variables of cervical cancer patients who receive concurrent chemoradiotherapy (CCRT) relate to each other. This study aimed to identify the symptom clusters in cervical cancer patients who receive CCRT and evaluate the mediating effect of illness perceptions on the relationship between symptom clusters and QoL. METHODS A cross-sectional survey was conducted on 286 cervical cancer patients receiving CCRT from October 2019 to October 2020. M.D. Anderson Symptom Inventory, Brief Illness Perception Questionnaire, and Functional Assessment Cancer Therapy-Cervix were applied to investigate the symptom clusters, illness perceptions and QoL of the participants, respectively. Exploratory factor analysis was conducted to identify symptom clusters. The relationships among symptom clusters, illness perceptions, and QoL were analyzed with the structural equation modeling. RESULTS A total of four symptom clusters were identified, including psychological status symptom cluster, therapy side-effect symptom cluster, sickness symptom cluster, and gastrointestinal symptom cluster (χ2 = 1,552.282, Df = 78, P < 0.001). Symptom clusters, illness perceptions, and QoL were significantly correlated. Symptom clusters had significant direct (β = -0.38, P < 0.001) and indirect effects (β = -0.21, P < 0.001) on QoL. CONCLUSION Illness perceptions played a significant mediating role between symptom clusters and QoL in cervical cancer patients receiving CCRT. Strategies like prompting effective symptom management for the purposes of alleviating illness perceptions may contribute to improving their QoL.
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Affiliation(s)
- Lan Zhang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.,Department of Health Psychology, School of Nursing, Shandong University, Jinan, China
| | - Jia Wang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Tangzhen Chen
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Min Tian
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Qimin Zhou
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Jianhua Ren
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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Long FJ, Chen H, Wang YF, He LM, Chen L, Liang ZB, Chen YN, Gong XH. Research on the effect of health care integration on patients’ negative emotions and satisfaction with lung cancer nursing activities. World J Clin Cases 2020; 8:4059-4066. [PMID: 33024763 PMCID: PMC7520783 DOI: 10.12998/wjcc.v8.i18.4059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/25/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lung cancer is a clinical disease with multiple malignant tumors. Currently, it is difficult for patients to benefit from routine clinical nursing due to the lack of a pertinent and systematic approach.
AIM To investigate the effect of integrated nursing care on the negative emotions and satisfaction of lung cancer patients.
METHODS From January 2018 to December 2019, 92 patients with lung cancer were selected and divided into the study group and the control group; there were 46 patients in each group. The control group received routine nursing, and the study group received integrated medical care in addition to the care received by the control group. Negative emotions before and after the intervention, the self-management ability score after the intervention, family care burden after the intervention and nursing satisfaction after the intervention were measured in the two groups.
RESULTS After the intervention, the self-rating anxiety scale and self-rating depression scale scores in the study group were lower than those in the control group (P < 0.05); the scores for health knowledge, self-concept, self-responsibility and self-care skills in the study group were higher than those in the control group (P < 0.05); the scores for individual burden and responsibility burden in the study group were lower than those before the intervention (P < 0.05); and the nursing satisfaction in the study group (93.48%) was higher than that in the control group (78.26%, P < 0.05).
CONCLUSION An integrated nursing care approach for lung cancer patients can effectively relieve the patient’s negative feelings, improve their self-management ability, help to reduce the burden of family care and improve patient satisfaction with nursing activities.
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Affiliation(s)
- Feng-Jiao Long
- Department of Thoracic Oncology, the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Hui Chen
- Department of Thoracic Oncology, the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Yue-Feng Wang
- Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Lan-Man He
- Department of Thoracic Oncology, the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Lin Chen
- Department of Thoracic Oncology, the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Zi-Bin Liang
- Department of Thoracic Oncology, the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Yan-Ni Chen
- Department of Otolaryngology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Xiao-Hua Gong
- Department of Thoracic Oncology, the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
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