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Wu S, Li K, Zhang Y, Wang L, Zhu B, Wang W. Men's symptom experience throughout androgen deprivation therapy for prostate cancer: A systematic review and meta-aggregation. Int J Nurs Stud 2024; 157:104796. [PMID: 38824718 DOI: 10.1016/j.ijnurstu.2024.104796] [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: 12/26/2023] [Revised: 03/20/2024] [Accepted: 05/02/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Androgen deprivation therapy is a common treatment for men with advanced prostate cancer. They have experienced many complex symptoms that affect their quality of life. However, qualitative reviews that synthesize the symptom experience for men with prostate cancer are lacking. OBJECTIVE To explore the men's symptom experience throughout androgen deprivation therapy for prostate cancer. DESIGN A qualitative evidence synthesis using meta-aggregation. DATA RESOURCES Published and unpublished literature between January 2001 and August 2023 were identified from PubMed, Embase (Ovid), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, ProQuest, Google Scholar, China National Knowledge Infrastructure (CNKI), Wang Fang, and VIP. REVIEW METHODS Two reviewers independently conducted screening, study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institutes Critical Appraisal Checklist for Qualitative Research. Data synthesis was conducted using meta-aggregative approach. RESULTS 24 articles of moderate to high methodological quality were included. A total of 98 findings were extracted with 59 unequivocal or equivocal findings eligible for meta-aggregation, aggregated into nine categories, and developed four synthesized findings: (1) production of symptoms: unrecognized and underestimated, (2) perception of symptoms: varied and complicated, (3) meaning of symptoms: threatened and affected, and (4) response to symptoms: push and pull. CONCLUSIONS Men throughout androgen deprivation for prostate cancer experience the four crisis-packed stages in their symptomatic journey. Health care provider need to understand the men's thoughts whether in the process of shared decision-making or in the course of the chosen therapy. Future research should develop individual suitable interventions and offer practical strategies for managing symptom. PROSPERO registration: CRD42023449129.
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Affiliation(s)
- Siyuan Wu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kun Li
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Zhang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Binbin Zhu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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Valaire R, Garden F, Razmovski‐Naumovski V. Are measures and related symptoms of cachexia recorded as outcomes in gastrointestinal cancer chemotherapy clinical trials? J Cachexia Sarcopenia Muscle 2024; 15:1146-1156. [PMID: 38533530 PMCID: PMC11154796 DOI: 10.1002/jcsm.13458] [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: 09/17/2023] [Revised: 01/30/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Cachexia is prevalent in gastrointestinal cancers and worsens patient outcomes and chemotherapy compliance. We examined to what extent registered gastrointestinal cancer chemotherapy clinical trials record measures and related symptoms of cachexia as outcomes, and whether these were associated with trial characteristics. METHODS Four public trial registries (2012-2022) were accessed for Phase II and/or III randomized controlled pancreatic, gastric, and colorectal cancer chemotherapy trial protocols. Trial outcome measures of overall survival and toxicity/side effects, and those related to cachexia [physical activity, weight/body mass index (BMI), dietary limitations, caloric intake, lean muscle mass] and symptoms (appetite loss, diarrhoea, pain, fatigue/insomnia, constipation, nausea, vomiting, and oral mucositis) were extracted, along with the number and types of performance status and patient-reported outcomes (PROs) tools. Data were summarized descriptively. Chi-square tests examined associations between outcomes and trial characteristics (cancer type, trial location, funding source, PROs tools, and commencement year). Statistical significance was set at P < 0.05. RESULTS We included 540 trial protocols (pancreatic (35.2%), colorectal (33.3%) and gastric (31.5%)), with most trials from Europe (44.1%). Trial lead investigator was from academia (28.3%), industry (27.6%) and government (26.3%). Allied health professional involvement (26.9%) occurred at eligibility. Adjuvant therapy in trials was mainly treatment-related (68.1%). Additional medication included anti-nausea (2.2%) and analgesia (0.9%). Trial protocols mostly recorded overall survival (90.4%) and toxicity (78.9%), and the symptoms appetite loss (26.1%) and diarrhoea (19.1%), with the other symptoms recorded in <10% of the trials. Reporting of physical activity (P = 0.001), dietary limitations (P = 0.002), lean muscle mass (P = 0.027), appetite loss (P < 0.001), pain (P = 0.001), nausea (P = 0.012), and oral mucositis (P = 0.049) varied depending cancer type. Toxicity/side effects (P = 0.022), physical activity (P < 0.001), appetite loss, nausea, and vomiting (all P < 0.001), diarrhoea (P = 0.010), pain (P = 0.001), fatigue/insomnia (P = 0.001) varied depending on the trial location. Trial funding was predominantly from private/industry (34.3%) and influenced the reporting of overall survival (P = 0.049), weight/BMI (P = 0.005), caloric intake (P = 0.015), and pain (P = 0.031). Performance status and PROs tools were mentioned in 91.2% and 46.3% of the trials, respectively. Trials that incorporated PROs tools were more likely to report cachexia related outcomes, except for overall survival, lean muscle mass, and oral mucositis. The proportion of trials measuring weight/BMI increased with trial commencement year (P = 0.04). CONCLUSIONS Cachexia-related outcomes were under-recorded in gastrointestinal cancer chemotherapy trials. As trial patients experience a high symptom burden, cachexia-relevant measures and symptoms should be assessed throughout the trial, and integrated with primary endpoints to support their progress.
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Affiliation(s)
- Ross Valaire
- Faculty of Medicine & Health, South West Sydney Clinical CampusesUniversity of New South Wales (UNSW) SydneyKensingtonNSWAustralia
| | - Frances Garden
- Faculty of Medicine & Health, South West Sydney Clinical CampusesUniversity of New South Wales (UNSW) SydneyKensingtonNSWAustralia
| | - Valentina Razmovski‐Naumovski
- Faculty of Medicine & Health, South West Sydney Clinical CampusesUniversity of New South Wales (UNSW) SydneyKensingtonNSWAustralia
- School of MedicineWestern Sydney UniversityCampbelltownNSWAustralia
- Ingham Institute of Applied Medical ResearchSydneyNSWAustralia
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Hou T. Depressive Symptoms, Sleep Quality, and Pain Are Associated With Frailty in Nursing Home Residents During the COVID-19 Pandemic. Pain Manag Nurs 2024; 25:241-248. [PMID: 38413256 DOI: 10.1016/j.pmn.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic has caused severe effects on older adults. Depressive symptoms, poor sleep quality, and pain are common in older adults with frailty. However, it is unknown the relationship between these symptoms and frailty in nursing home residents and the difference of importance between pain intensity and pain impact on frailty during the COVID-19 Pandemic. Therefore, this study aims to explore the associations between depressive symptoms, poor sleep quality, pain intensity, and pain impact with frailty in older adults living in nursing homes. METHODS In this cross-sectional population-based study, 172 older adults living in nursing homes from Changsha in China were included. We collected data on depressive symptoms, sleep quality, pain, and frailty using the Patient Health Questionnaire, the Pittsburgh Sleep Quality, the Brief Pain Inventory-short form, and the FRAIL-NH Scale. Generalized linear regression models were used to explore the interaction association between these symptoms with frailty. RESULTS Most older adults were between 80 and 90 years old. Approximately 11.6% of older adults experienced one of the following symptoms: depressive symptoms, poor sleep quality, pain intensity, or pain impact. Moreover, 76.7% of older adults experienced at least two of these symptoms. The most common overlapping symptoms were depressive symptoms and poor sleep quality (14.5%). Among nursing home residents, the most common sites of pain were the lower limbs, followed by the back. There was a strong correlation between depressive symptoms, sleep quality, pain intensity, pain impact, and frailty. After adjusting for covariates, the interaction term between any two or three symptoms of depressive symptoms, poor sleep quality, pain intensity, and pain impact was found to be associated with a higher likelihood of frailty in older adults residing in nursing homes (p< .05). CONCLUSIONS Depressive symptoms, poor sleep quality, pain intensity, and pain impact are common among nursing home residents. Furthermore, these symptoms interacted with each other. In future studies, multidisciplinary interventions aimed at releasing these symptoms and reducing the adverse outcome of frailty are needed.
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Affiliation(s)
- Tianxue Hou
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Albusoul RM, Hasanien AA, Abdel Razeq NM, Al-Maharma DY. Symptom Clusters and Their Impact on Spiritual Well-Being Among Women with Breast Cancer. Int J Womens Health 2024; 16:961-970. [PMID: 38827927 PMCID: PMC11144402 DOI: 10.2147/ijwh.s463840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/23/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose To explore symptom experience and symptom clusters among Jordanian women with breast cancer and investigate whether these clusters predict patients' spiritual well-being. Patients and Methods A sample of 142 Jordanian women with breast cancer were asked to complete the Memorial Symptom Assessment Scale (MSAS), Functional Assessment of Chronic Illness Therapy- Spiritual Well-being (FACIT-Sp) scale, and socio-demographic questionnaire. Exploratory factor analysis was used to group symptoms into clusters, and multiple linear regression was used to explore the symptom clusters that predict spiritual well-being. Results The most prevalent symptoms among women with breast cancer were fatigue, anxiety, tension, and pain. All these symptoms have a prevalence greater than 50%. Three clusters were found: treatment-related symptom cluster consisting of eight symptoms, gastrointestinal symptom cluster consisting of seven symptoms, and psychological symptom cluster consisting of five symptoms. The psychological symptom cluster was the only cluster predicting the women's spiritual well-being (t (141) = -3.049; p < 0.01). Conclusion Women with breast cancer experience several concurrent symptoms and symptom clusters. Screening for psychological symptom clusters and their treatment improves patients' spiritual well-being. The majority of women with breast cancer did not receive any complementary therapies and hardly any spiritual or psychological support, which should be provided in the future to support their spiritual well-being.
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Affiliation(s)
- Randa M Albusoul
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Amer A Hasanien
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Nadin M Abdel Razeq
- Department of Maternal and Child Health Nursing, School of Nursing, The University of Jordan, Amman, Jordan
| | - Dua’ Y Al-Maharma
- Department of Maternal and Child Health Nursing, School of Nursing, The University of Jordan, Amman, Jordan
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5
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Bernal-Cárdenas CY, Céspedes-Cuevas VM, Rojas-Reyes J. Cognitive predictors and decision-making in the experience of coronary syndrome symptoms. ENFERMERIA INTENSIVA 2024; 35:124-132. [PMID: 38245496 DOI: 10.1016/j.enfie.2023.06.003] [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: 01/13/2023] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE To determine the predictive value of Cognitive Assessment, Symptom Severity, Personal Control and Self-Efficacy on decision making in the experience of Acute Coronary Syndrome symptoms. METHOD Quantitative study of cross-sectional analytical design, a probabilistic sampling was carried out for 256 participants diagnosed with coronary syndrome in three health institutions. The effects between the independent variables Cognitive Assessment, Symptom Severity, Personal Control, Self-Efficacy and the dependent Decision-Making were analyzed. Using inferential statistics, a Generalized Linear Regression Model was carried out, which allowed establishing the causal relationships between the variables. RESULTS Two predictive models were obtained between decision making and cognitive evaluation, in which personal control, severity of symptoms, sex and context were significant. Self-efficacy was not reported as a predictor variable. The values of the independent variables showed a behavior directly proportional to the Decision Making score. CONCLUSION A verification of the conceptual model for the management of symptoms was carried out.
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Affiliation(s)
| | | | - J Rojas-Reyes
- Facultad de Enfermería, Universidad de Antioquia, Medellín, Colombia
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Nicol C, Pinkham MB, Lion K, Foote M, McBean A, Higgins M, Conlon E, Ownsworth T. Individuals' perceptions of health and well-being in the context of stereotactic radiosurgery for benign brain tumour: A longitudinal qualitative investigation. Neuropsychol Rehabil 2024; 34:244-267. [PMID: 36927243 DOI: 10.1080/09602011.2023.2181190] [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: 08/28/2022] [Accepted: 02/10/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Treatment-related outcomes after Gamma Knife Stereotactic Radiosurgery (GKSRS) for benign brain tumour are well-established; yet patient reported outcomes have been largely overlooked. This study explored individuals' perspectives of their health and well-being prior to and following GKSRS. METHOD Twenty adults (65% female) aged 24-71 years with benign brain tumour were recruited from a major metropolitan hospital and assessed approximately one week prior to, two weeks after, and at three months following GKSRS. They completed telephone-based interviews focusing on general health, symptoms, and well-being. Interviews were transcribed and analysed using thematic analysis. RESULTS Three major themes characterized individuals' perceptions of their health and well-being. "Understanding my Illness and Treatment" reflected individuals' efforts to make sense of their illness and symptoms to reduce ambiguity and increase sense of control. "Experiencing Gamma Knife" related to expectations of the procedure, outcomes, daily impacts, and emotional reactions. "Adjusting one's Mindset and Coping" characterised how peoples' approaches to coping with their illness were altered over time. CONCLUSIONS Coping and adjustment is highly individualistic in the context of GKSRS. Over time, most individuals were able to make sense of their illness, adjust their mindset and utilize behavioural strategies and support systems to cope with the long-term effects.
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Affiliation(s)
- Chelsea Nicol
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Mount Gravatt, Australia
| | - Mark B Pinkham
- School of Medicine, University of Queensland, Brisbane, Australia
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Katarzyna Lion
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Mount Gravatt, Australia
| | - Matthew Foote
- School of Medicine, University of Queensland, Brisbane, Australia
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Angela McBean
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Mary Higgins
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
| | - Elizabeth Conlon
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Mount Gravatt, Australia
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7
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Zhao D, Ma Q, Li G, Qin R, Meng Y, Li P. Treatment-induced menopause symptoms among women with breast cancer undergoing chemotherapy in China: a comparison to age- and menopause status-matched controls. Menopause 2024; 31:145-153. [PMID: 38086004 DOI: 10.1097/gme.0000000000002296] [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: 01/26/2024]
Abstract
OBJECTIVE Whether women with breast cancer experience more severe menopause symptoms than comparison women without a history of breast cancer diagnosis remains unclear. We aimed to investigate whether women with breast cancer undergoing chemotherapy experience more severe menopause symptoms than comparison women and explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy. METHODS This cross-sectional observational study recruited 423 women with breast cancer undergoing chemotherapy and 1,829 community women without breast cancer. All participants completed a questionnaire assessing menopause symptoms using the Menopause Rating Scale and general characteristics (eg, sociodemographic and clinical data). Propensity score matching was used to reduce the confounders between the two groups. Student's t test or Mann-Whitney U test and chi-square tests were used to compare the differences in menopause symptoms between the two groups. Multivariate linear regression analysis was performed to explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy. RESULTS After propensity score matching, 808 participants were included. The mean ages of women with breast cancer undergoing chemotherapy and comparison women were 49.58 and 49.10 years, respectively. Women with breast cancer undergoing chemotherapy experienced significantly more severe vasomotor symptoms than comparison women. However, comparison women had higher Menopause Rating Scale scores and more severe menopause symptoms than women with breast cancer undergoing chemotherapy. Age, occupational status, chemotherapy-induced amenorrhea, family history of cancer, chemotherapy stage, mindfulness, resiliency, and illness perception were associated with menopause symptoms in women with breast cancer undergoing chemotherapy. CONCLUSIONS Vasomotor symptoms are prominent among women with breast cancer undergoing chemotherapy. Understanding the factors contributing to menopause symptoms is crucial for healthcare practitioners to develop supportive guidelines for the well-being of women with breast cancer undergoing chemotherapy.
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Affiliation(s)
- Di Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Qinghua Ma
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Guopeng Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Rui Qin
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yingtao Meng
- Nursing Department, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Ping Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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McKay MA, Cohn A, O'Connor M. The Symptom Experience of Older Adults with Mobility Difficulties: Qualitative Interviews. J Appl Gerontol 2024; 43:129-138. [PMID: 37994808 DOI: 10.1177/07334648231205420] [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: 11/24/2023] Open
Abstract
Eighteen million older adults have mobility limitations, defined as difficulty walking a quarter of a mile or climbing stairs unassisted. Little is known about how symptom burden impacts mobility difficulty in older adults. Understanding the burden of symptoms responsible for mobility difficulties may be an area for intervention to improve mobility and to prevent adverse outcomes. We conducted 31 semi-structured qualitative interviews (one interview per participant) regarding the symptom burden experience associated with a current mobility difficulty. Thematic analysis revealed symptoms were limiting, were barriers to participation in daily activities, and produced a psychological and emotional burden that negatively impacted quality of life. Older adults employed various strategies to overcome the symptom burden. Participants also believed symptoms were a non-modifiable part of the aging process and at times felt disregarded by healthcare professionals. Future interventions should focus on reducing the symptom burden experience for older adults to improve mobility and prevent adverse outcomes.
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Affiliation(s)
- Michelle A McKay
- Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Alexis Cohn
- Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Melissa O'Connor
- Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
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Ma Y, Lu Z, Qiu J, Luo H, Tang L, Li Y, Li P. Symptom experience in endocrine therapy for breast cancer patients: A qualitative systematic review and meta-synthesis. Asia Pac J Oncol Nurs 2024; 11:100364. [PMID: 38293603 PMCID: PMC10827404 DOI: 10.1016/j.apjon.2023.100364] [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: 11/07/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024] Open
Abstract
Objective The purpose of this study was to systematically integrate the experience of symptoms of breast cancer patients receiving endocrine therapy, analyze the patients' understanding and coping status of symptoms, and provide information for the development of targeted symptom management measures. Methods We searched databases including PubMed/MEDLINE, MEDLINE (Ovid), Web of Science, EMBASE (Ovid), CINAHL (EBSCO), and ProQuest from inception to September 25, 2023. Literature was screened and analyzed using Endnote software, evaluated using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research, and the results were integrated using JBI's Pooled Integration Methodology. Results Three composite findings were derived from 10 studies: symptom distress during endocrine therapy; coping in symptom experience; and support needs. Conclusions Emphasis should be placed on the symptomatic experience of breast cancer patients undergoing endocrine therapy, and effective interventions should be developed to improve patients' medication compliance and quality of life. Finally, the long-term survival rate of patients is improved. Systematic review registration CRD42023466073.
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Affiliation(s)
- Yan Ma
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhenqi Lu
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiajia Qiu
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Huiyu Luo
- Department of Nursing, Fujian Cancer Hospital, Fujian, China
| | - Lichen Tang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yun Li
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ping Li
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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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.
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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
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11
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Chen Y, Fang Y, Liu M, Yao R, Wan J. Taste alterations in patients following hematopoietic stem cell transplantation: A qualitative study. Asia Pac J Oncol Nurs 2023; 10:100311. [PMID: 38033392 PMCID: PMC10685015 DOI: 10.1016/j.apjon.2023.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/24/2023] [Indexed: 12/02/2023] Open
Abstract
Objective This study aims to explore the experiences and consequences of taste alterations in patients undergoing HSCT, how they respond to these changes, and the factors that influence their responses. Methods In this descriptive qualitative study, face-to-face semi-structured individual interviews were conducted with 31 patients undergoing HSCT in a comprehensive hospital in Hubei, China. The interview data were transcribed and analyzed using Colaizzi's seven-step analysis. The Symptom Management Theory was applied to design the study and identify key themes. Results Three key themes were identified from the theory: (1) the complexity and diversity of taste experiences; (2) coping strategies; and (3) the multifaceted challenges of coping. Taste alterations in HSCT patients were characterized by diversity and dynamism. Patients employed three distinct coping styles in response to taste alterations: active coping, reluctant submission, and passive coping. These coping styles were influenced by various factors, including the specific treatment modalities of HSCT, individual patient characteristics, and the healthcare environment. Conclusions The experience of taste alterations among HSCT patients is intricate and varied, and the importance of addressing this symptom can easily be underestimated. Management of taste alterations is influenced by multiple factors. Nursing staff should give careful attention to taste alterations in HSCT survivors, enhance their expertise in managing taste alterations, provide robust health education, conduct regular screening and assessments, and formulate individualized intervention plans to assist patients in actively and effectively managing taste alterations.
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Affiliation(s)
- Yuanyuan Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Fang
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minjie Liu
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruishan Yao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Wan
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Miller M, Vachon E, Kwekkeboom K. Cancer-Related Symptom Frameworks Using a Biopsychosocial-Spiritual Perspective: A Scoping Review. West J Nurs Res 2023; 45:963-973. [PMID: 37665278 DOI: 10.1177/01939459231193698] [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: 09/05/2023]
Abstract
BACKGROUND Research to understand and manage cancer-related symptoms continues to advance, yet work that more fully adopts a biopsychosocial-spiritual view of symptoms is needed. OBJECTIVE The purpose of this article is to review existing frameworks that have the potential to guide research on cancer-related symptoms, to explore the characteristics of each framework, and to appraise each using a biopsychosocial-spiritual lens. METHODS A scoping review was conducted to identify available frameworks that could be applied to guide cancer-related symptom research and to assess their characteristics. Research questions and criteria were formulated at the outset, followed by identifying relevant publications detailing novel frameworks, charting data, and collating results. Upon identification of available frameworks, each was appraised for alignment with a standard definition of "biopsychosocial-spiritual." RESULTS Eleven frameworks were identified to guide cancer-related symptom research. All were developed in the United States, led by nurse scientists, including symptom experiences as well as their antecedents and outcomes, and could be applied to one or more concurrent cancer-related symptoms. While all 11 frameworks included biopsychosocial dimensions, only 4 included spirituality. CONCLUSIONS Four biopsychosocial-spiritual frameworks offer unique insight to support advancement of cancer-related symptom research and practice from a holistic perspective. This foundational work could lead to development and validation of new frameworks and modification of existing frameworks to more closely align with a biopsychosocial-spiritual view of cancer-related symptoms. This review offers a starting point to carefully and explicitly adopt frameworks in research and practice with increased emphasis on considering spiritual dimensions of symptoms.
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Affiliation(s)
- Megan Miller
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Eric Vachon
- Department of Community and Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA
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Cheng HL, Yeung WF, Wong HF, Lo HT, Molassiotis A. Self-Acupressure for Symptom Management in Cancer Patients: A Systematic Review. J Pain Symptom Manage 2023; 66:e109-e128. [PMID: 36898639 DOI: 10.1016/j.jpainsymman.2023.03.002] [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: 08/25/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023]
Abstract
CONTEXT Acupressure is a popular nonpharmacological intervention that is increasingly proven to effectively alleviate symptoms in patients with cancer. However, the effects of self-acupressure on cancer symptom management are less clear. OBJECTIVES This systematic review is the first to summarize the current experimental evidence on self-acupressure for symptom management in cancer patients. METHODS Eight electronic databases were searched for experimental studies that examined self-acupressure for cancer patients with symptoms and published in peer-reviewed English or Chinese journals. The methodological quality of the included studies was evaluated using the revised Cochrane risk-of-bias assessment tool and the JBI critical appraisal checklist for quasi-experimental studies. Data were extracted as predefined and synthesized narratively. The Template for Intervention Description and Replication checklist was used to report the intervention characteristics. RESULTS A total of 11 studies were included in this study, six as feasibility or pilot trials. The methodological quality of included studies was suboptimal. Substantial heterogeneity was observed in acupressure training, acupoint selection, intervention duration, dosage, and timing. Self-acupressure was only associated with reduced nausea and vomiting (P = 0.006 and P = 0.001). CONCLUSION The limited evidence from this review precludes the definitive conclusions on intervention effectiveness for cancer symptoms. Future research should consider developing the standard protocol for intervention delivery, improving the methodology of self-acupressure trials, and conducting large-scale research to advance the science of self-acupressure for cancer symptom management.
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Affiliation(s)
- Hui-Lin Cheng
- School of Nursing (H.L.C., W.F.Y., H.F.W., H.T.L.), The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| | - Wing-Fai Yeung
- School of Nursing (H.L.C., W.F.Y., H.F.W., H.T.L.), The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Hon-Fat Wong
- School of Nursing (H.L.C., W.F.Y., H.F.W., H.T.L.), The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Huen-Ting Lo
- School of Nursing (H.L.C., W.F.Y., H.F.W., H.T.L.), The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Alex Molassiotis
- College of Arts, Humanities, and Education (A.M.), University of Derby, Derby, England
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Zeng L, Huang H, Liu Y, Ruan C, Fan S, Xia Y, Zhou J. The core symptom in multiple myeloma patients undergoing chemotherapy: a network analysis. Support Care Cancer 2023; 31:297. [PMID: 37097532 PMCID: PMC10126563 DOI: 10.1007/s00520-023-07759-7] [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: 11/23/2022] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND During chemotherapy for multiple myeloma, symptoms include those related to the disease, as well as adverse effects of the treatment. Few studies have explored the relationships between these symptoms. Network analysis could identify the core symptom in the symptom network. OBJECTIVE The aim of this study was to explore the core symptom in multiple myeloma patients undergoing chemotherapy. METHODS This was a cross-sectional study in which sequential sampling was used to recruit 177 participants from Hunan, China. Demographic and clinical characteristics were surveyed using a self-developed instrument. The symptoms of chemotherapy-treated multiple myeloma, including pain, fatigue, worry, nausea, and vomiting, were measured using a questionnaire with good reliability and validity. The mean ± SD, frequency, and percentages were used as descriptive statistics. Network analysis was used to estimate the correlation between symptoms. RESULTS The results showed that 70% of multiple myeloma patients using chemotherapy exhibited pain. In the network analysis, worrying was the dominant symptom, and the strongest relationship was between nausea and vomiting in chemotherapy-treated multiple myeloma patients' symptoms. CONCLUSION Worrying is the core symptom of multiple myeloma patients. Interventions could be most effective if there is a symptom management focus on worrying when providing care to chemotherapy-treated multiple myeloma patients. Nausea combined with vomiting could be better managed, which would decrease the cost of health care. Understanding the relationship between the symptoms of multiple myeloma patients undergoing chemotherapy is beneficial for precise symptom management. IMPLICATIONS FOR PRACTICE Nurses and health care teams should be a priority to intervene in the worrying for chemotherapy-treated multiple myeloma patients to maximize the effectiveness of an intervention. Except, nausea and vomiting should be managed together in a clinical setting.
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Affiliation(s)
- Lihong Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Huang
- The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Yaqi Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunhong Ruan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Sisi Fan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuting Xia
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiandang Zhou
- The Third Xiangya Hospital, Central South University, Changsha, China.
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Guttormson JL, Khan B, Brodsky MB, Chlan LL, Curley MAQ, Gélinas C, Happ MB, Herridge M, Hess D, Hetland B, Hopkins RO, Hosey MM, Hosie A, Lodolo AC, McAndrew NS, Mehta S, Misak C, Pisani MA, van den Boogaard M, Wang S. Symptom Assessment for Mechanically Ventilated Patients: Principles and Priorities: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2023; 20:491-498. [PMID: 37000144 PMCID: PMC10112406 DOI: 10.1513/annalsats.202301-023st] [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: 04/01/2023] Open
Abstract
Mechanically ventilated patients experience many adverse symptoms, such as anxiety, thirst, and dyspnea. However, these common symptoms are not included in practice guideline recommendations for routine assessment of mechanically ventilated patients. An American Thoracic Society-sponsored workshop with researchers and clinicians with expertise in critical care and symptom management was convened for a discussion of symptom assessment in mechanically ventilated patients. Members included nurses, physicians, a respiratory therapist, a speech-language pathologist, a critical care pharmacist, and a former intensive care unit patient. This report summarizes existing evidence and consensus among workshop participants regarding 1) symptoms that should be considered for routine assessment of adult patients receiving mechanical ventilation; 2) key symptom assessment principles; 3) strategies that support symptom assessment in nonvocal patients; and 4) areas for future clinical practice development and research. Systematic patient-centered assessment of multiple symptoms has great potential to minimize patient distress and improve the patient experience. A culture shift is necessary to promote ongoing holistic symptom assessment with valid and reliable instruments. This report represents our workgroup consensus on symptom assessment for mechanically ventilated patients. Future work should address how holistic, patient-centered symptom assessment can be embedded into clinical practice.
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Luo J, Liu R, Luo Y, Fang Q, Liu S, Yang Z, Miao J, Zhang L. The high burden of symptoms associated with cognitive impairment in lung cancer patients: A latent class analysis. Asia Pac J Oncol Nurs 2023; 10:100200. [PMID: 36890861 PMCID: PMC9988398 DOI: 10.1016/j.apjon.2023.100200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Objective To explore the association between the pain-fatigue-sleep disturbance-depression symptom cluster (SC) and cancer-related cognitive impairment (CRCI) in patients having lung cancer and to identify other factors influencing CRCI. Methods A cross-sectional study was conducted to investigate 378 patients having lung cancer in China from October 2021 to July 2022. The perceived cognitive impairment scale and the general anxiety disorder-7 were used to assess patients' cognitive impairment and anxiety, respectively. The pain-fatigue-sleep disturbance-depression SC was assessed with the brief fatigue inventory, the brief pain inventory, the Patient Health Questionnaire-9, and the Athens Insomnia Scale. Latent class analysis by Mplus.7.4 was used to identify latent classes of the SC. We adjusted for covariates in the multivariable logistic regression model to examine the relationship between the pain-fatigue-sleep disturbance-depression SC and CRCI. Results Among patients having lung cancer, two SC classes were identified: high and low symptom burden groups. In the crude model, compared to the low symptom burden group, the high symptom group had greater odds of developing CRCI (odds ratio: 10.065, 95% confidence interval: 4.138-24.478). After adjusting for covariates, in model 1, the high symptom group still had greater odds of developing CRCI (odds ratio: 5.531, 95% confidence interval: 2.133-14.336). Additionally, a diagnosis of over 6 months, anxiety, leisure activity, and a high platelet-to-lymphocyte ratio were found to be influencing factors of CRCI (all P < 0.05). Conclusions Our study revealed that a high symptom burden is a significant risk factor for CRCI, which may provide a new perspective for managing CRCI in lung patients having cancer.
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Affiliation(s)
- Jiahui Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ruiqi Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Qinghong Fang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Suting Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
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17
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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.
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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
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Abstract
BACKGROUND The National Institute of Nursing Research developed the National Institutes of Health symptom science model (SSM) in 2015 as a parsimonious conceptual model to guide symptom science research. OBJECTIVES This concept development paper synthesizes justifications to strengthen the original model. METHODS A literature review was performed, discussions with symptom science content expert stakeholders were held, and opportunities for expanding the current model were identified. Concept elements for a revised conceptual model-the SSM 2.0-were developed. RESULTS In addition to the four original concept elements (complex symptom presentation, phenotypic characterization, biobehavioral factors [previously biomarker discovery], and clinical applications), three new concept elements are proposed, including social determinants of health, patient-centered experience, and policy/population health. DISCUSSION There have been several calls to revise the original SSM from the nursing scientific community to expand its utility to other healthcare settings. Incorporating three additional concept elements can facilitate a broader variety of translational nursing research symptom science collaborations and applications, support additional scientific domains for symptom science activities, and produce more translatable symptom science to a wider audience of nursing research scholars and stakeholders during recovery from the COVID-19 pandemic. The revised SSM 2.0 with newly incorporated social determinants of health, patient-centered experience, and policy/population health components now empowers nursing scientists and scholars to address specific symptom science public health challenges particularly faced by vulnerable and underserved populations.
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19
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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.
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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
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20
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Xie M, Wang A, Wang K, Yu Y, Lin Z. Association between HIV duration and symptom distress among middle-aged and elderly people with HIV-infected in China: a cross-sectional study. BMC Geriatr 2022; 22:728. [PMID: 36058926 PMCID: PMC9442943 DOI: 10.1186/s12877-022-03411-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background Debate has persisted regarding whether PLWH with longer HIV durations have lower levels of prevalence and severity of symptoms compared with their newly diagnosed counterparts. Whether and how the HIV duration impact the symptom distress among middle-aged and older PLWH has not been explored clearly. Methods The patients with HIV-infected aged more than 40 years old were included from seven designated medical institutions of seven regions in China. Outcome was the score of symptom distress. We used the multiple regression model to calculate adjusted Coefficient of Regression (β) with 95% CI in this study. Results Among 210 participants (mean age 50.8 years; 71.0% male; 68.1% at asymptomatic stage) in the study, the median number of symptoms was 5. Of all symptoms reported, the most distressed symptoms were sleep disturbance (33.33%), followed by memory loss (31.90%), fatigue (26.67%), slow reactions (22.86%), and vision blur (21.90%). All participants were divided into four groups according to HIV duration, and the median of total score of symptom ditress among all participants was 0.1(0.0,0.9). Difference of total scores and clusters’ scores of symptom distress among four HIV duration groups were statistically significant. 51 participants with 6–10 years HIV duration were more likely to be higher level of education, at asymptomatic stage and have higher CD4 + T cell count. After adjustment for gender, age, race, education, marital status, employment, family income, region, stage of disease and CD4 + T cell count, the score of symptom distress among participants with 6–10 years HIV duration had was higher with the extension of HIV duration. Specially in physical symptoms and psychological symptoms,participants with 6–10 years HIV duration reported the persisting worse burdensome. Conclusions HIV duration with 6–10 yearsmay be a key period that the medical team needs to pay special attention to among middle-aged and elderly PLWH. There is a need to provide medical and psychosocial services targeting middle-aged and elderly PLWH according to their changing symptom distress. Trial registration Clinicaltrials.gov: ChiCTR2100046225. Registered 11 May 2021.
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Affiliation(s)
- Meilian Xie
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.,Department of Nursing, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
| | - Kerong Wang
- Beijing Home of Red Ribbon, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Yanping Yu
- Beijing Home of Red Ribbon, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Zhaoxia Lin
- Department of Quality Control, Beijing Ditan Hospital Capital Medical University, Beijing, China
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Xiang L, Yoon S, Low AHL, Leung YY, Fong W, Lau TC, Koh DR, Thumboo J. Approaches to improving symptom appraisal: a systematic literature review. BMJ Open 2022; 12:e064521. [PMID: 35998970 PMCID: PMC9403152 DOI: 10.1136/bmjopen-2022-064521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Poor symptom appraisal (detection, interpretation and response to symptoms) plays a major role in prolonged prediagnosis interval in various health conditions. Theories and models have been proposed to study the symptom appraisal process but how they could be employed to improve symptom appraisal remains unclear. We therefore aimed to review approaches to improving symptom appraisal in the literature and to develop a theoretical framework that could guide the development of approaches to improving symptom appraisal among individuals in the general population. DESIGN Systematic review. DATA SOURCES Medline, Web of Science, PsycINFO, Embase, CINAHL and Scopus were searched from inception to 30 March 2021. ELIGIBILITY CRITERIA We included original articles in English in which approaches to improve the detection, interpretation or response to symptoms for symptomatic individuals were described. We excluded articles in which approaches were developed to improve symptom appraisal among healthcare professionals. DATA EXTRACTION AND SYNTHESIS A predefined data extraction form was used to extract the development, characteristics and evaluation of approaches to improving symptom appraisal. This formed the basis for the narrative synthesis. RESULTS Of 19 046 publications identified from the literature search, 112 were selected for full-text review and 29 approaches comprising provision of knowledge of symptoms/signs and additional components (eg, symptom self-examination and comparison) for symptom appraisal were included in the synthesis. Less than half (41.4%) of these approaches were developed based on theories/models. Interestingly, despite the variety of theories/models adopted in developing these approaches, the components of these approaches were similar. CONCLUSION Symptom appraisal is an essential process in a patient's journey that can be targeted to facilitate early diagnosis but is largely unstudied. Building on the literature, we proposed a theoretical framework and approaches to improving symptom appraisal. This could facilitate early identification of a variety of health conditions in the general population. TRIAL REGISTRATION NUMBER CRD42021279500.
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Affiliation(s)
- Ling Xiang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Andrea H L Low
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Tang Ching Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore
| | - Dow Rhoon Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
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22
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Chang L, Zhang S, Yan Z, Li C, Zhang Q, Li Y. Symptom burden, family resilience, and functional exercise adherence among postoperative breast cancer patients. Asia Pac J Oncol Nurs 2022; 9:100129. [PMID: 36158704 PMCID: PMC9500512 DOI: 10.1016/j.apjon.2022.100129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Methods Results Conclusions Postoperative breast cancer patients self-report they have a higher level of family resilience. Postoperative breast cancer patients with higher functional exercise adherence have less symptom burden. Family resilience can indirectly alleviate postoperative breast cancer patients' symptom burden.
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Chen L, Jia S, Li P, Shi Z, Li Y. Experiences and coping strategies of somatic symptoms in patients with depressive disorder: A qualitative study. Arch Psychiatr Nurs 2022; 38:6-13. [PMID: 35461645 DOI: 10.1016/j.apnu.2022.01.004] [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: 12/11/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Depressive disorder is the most prevalent mental illness and is characterised by the presence of mental and somatic symptoms, with the latter affecting 65.0% to 98.2% of patients with their general function and quality of life. PURPOSE The purpose of this study aimed to explore the experiences and coping strategies of somatic symptoms in Chinese patients with depressive disorder, and to gain new insight into the illness and the health care provided to patients. METHODS Semi-structured, in-depth interviews were conducted with 15 patients diagnosed with depressive disorder according to international classification of diseases 10th revision. The interviews were transcribed verbatim and the thematic analysis was adapted to the data. MAXQDA10 software was used to organise, encode, classify, induce, and extract themes. RESULTS Four major themes were extracted from the interviews: (1) descriptions of symptoms; (2) perceptions of the symptoms; (3) symptom disturbance; and (4) coping strategies of symptoms. Within the first theme, patients identified the following sub-themes: complex experiences of somatic symptoms, which were mainly in the neuromuscular system, circulatory respiratory system, gastrointestinal system and some symptoms without obvious systemic classification; difficulty in locating symptoms accurately; and being not consistent with examination results. The second theme included patient's inadequate understanding of somatic symptoms; and denial of the link between physical discomfort and depression. Disturbance of somatic symptoms embraced three sub-themes: (1) Uncertainty about somatic symptoms; (2) Struggling with daily life; (3) Impact on social activities; (4) feeling a decrease in family support. Lastly, coping strategies taken by patients in the face of various symptoms mainly included relying on drug treatment, avoiding stressors, diverting attention, and compromise or acceptance. CONCLUSIONS Patients with depressive disorder experience a variety of somatic symptoms that have a negative impact on social function and reduce their quality of life. Patients did not have an adequate understanding of their physical discomfort and lacked effective coping strategies for these somatic symptoms. Professional staff should pay more attention to patients' somatic symptoms and focus on targeted symptom management to facilitate patient recovery.
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Affiliation(s)
- Li Chen
- School of Nursing, Fudan University, No. 305, Feng Lin Road, Shanghai 200032, PR China
| | - Shoumei Jia
- School of Nursing, Fudan University, No. 305, Feng Lin Road, Shanghai 200032, PR China.
| | - Ping Li
- Putuo Mental Health Centre, Shanghai 200065, PR China
| | - Zhongying Shi
- Nursing Department, Shanghai Mental Health Centre, Shanghai 200032, PR China
| | - Yang Li
- School of Nursing, Fudan University, No. 305, Feng Lin Road, Shanghai 200032, PR China.
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Risom SS, Nørgaard MW, Streur MM. Quality of life and symptom experience measurement tools in adults with atrial fibrillation: a scoping review protocol. JBI Evid Synth 2022; 20:1376-1384. [PMID: 34937845 DOI: 10.11124/jbies-21-00167] [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: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review is to identify and map measurement tools for evaluating disease-specific quality of life and symptoms in adults with atrial fibrillation. The review will also identify key concepts that differentiate quality of life from symptom experience. INTRODUCTION Quality of life is a broad concept influenced by physical health, psychological state, degree of independence, and social/functional status. Symptoms of a chronic disease may influence quality of life through their effect on an individual's perception of physical health. Symptom experience is distinct from quality of life; however, the distinction is ill-defined, resulting in conceptual overlap in the measurement tools used to assess these concepts in patients with atrial fibrillation. INCLUSION CRITERIA Included manuscripts will describe a scale, index, questionnaire, checklist, or other form of measurement tool designed to assess quality of life or symptom experience in adults with atrial fibrillation or supraventricular arrhythmia. Peer-reviewed research manuscripts and systematic reviews, gray literature, and conceptual/theoretical papers will be included. METHODS The review will follow the JBI methodology for scoping reviews. MEDLINE, CINAHL, PsycINFO, the Cochrane Database of Systematic Reviews, and Embase will be searched, as well as Google Scholar, MedNar, and OpenGrey. Articles will be considered if they are published in English, Danish, Swedish, or Norwegian, with no date limitation. The title and abstract of each article will be independently screened by two authors, followed by full-text review of remaining articles, according to the inclusion criteria. Data will be independently extracted by two authors using a data extraction tool.
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Affiliation(s)
- Signe S Risom
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen O, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen O, Denmark
- Institute of Nursing and Nutrition, University College Copenhagen, Copenhagen N, Denmark
- Cardiology Department, Gentofte and Herlev University Hospital, Hellerup, Denmark
| | - Marianne W Nørgaard
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen O, Denmark
- Danish Centre of Systematic Reviews: A JBI Centre of Excellence, Center for Clinical Guidelines, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Megan M Streur
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
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Lescoat A, Murphy SL, Chen YT, Vann N, Galdo FD, Cella D, Buch MH, Khanna D. Symptom experience of limited cutaneous systemic sclerosis from the Patients' perspective: A qualitative study ✰,✰✰,★,★★. Semin Arthritis Rheum 2022; 52:151926. [PMID: 34785028 PMCID: PMC9131352 DOI: 10.1016/j.semarthrit.2021.11.003] [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] [Received: 07/28/2021] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Limited cutaneous systemic sclerosis (lcSSc) is the largest subgroup of people with SSc, but little is known about symptom experience from the patients' perspective. This study aimed to comprehensively identify domains and symptoms reported as bothersome by patients with lcSSc and to analyze themes and sub-themes capturing symptom experience in this population. METHODS Focus groups of patients with lcSSc were conducted using a structured guide. Patients were recruited based on an a priori purposive framework to include men and women with SSc. Focus groups were recorded, transcribed, anonymized, and analyzed using the RADaR technique (rigorous and accelerated data reduction) combined with iterative, deductive and inductive approaches. RESULTS Four 2-hour Focus groups comprising participants with lcSSc were conducted (N = 26). Ninety-four symptoms were identified with 22 domains. Symptoms from the following domains were mentioned in all Focus groups: skin, musculoskeletal (MSK), cardiac, pulmonary, gastro-intestinal (GI) manifestations, fatigue, sleep, Raynaud's phenomenon (RP), pain, and digital ulcers. The three most cited domains in a pre-meeting survey were GI, RP and MSK. Seven themes defining symptom experience were identified: difficulty attributing symptoms to this complex systemic disease, influence of symptom temporality, impairment of emotional well-being, limitations in functioning (including several sub-themes of functioning), survival, symptoms management and uncertainty. CONCLUSION This study comprehensively identified domains and symptoms considered bothersome from the perspective of patients with lcSSc and summarized patient experience of lcSSc-related symptoms. This study is the first step in the design of a future combined response index dedicated to lcSSc that could foster specific research on this subpopulation of patients.
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Affiliation(s)
- Alain Lescoat
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France; Michigan Scleroderma Program, University of Michigan, Ann Arbor, MI, USA
| | - Susan L Murphy
- Michigan Scleroderma Program, University of Michigan, Ann Arbor, MI, USA; Department of Physical Medicine & Rehabilitation, University of Michigan, USA; VA Ann Arbor Healthcare System, Geriatric Research Education and Clinical Center, GRECC, Ann Arbor, MI USA.
| | - Yen T Chen
- Michigan Scleroderma Program, University of Michigan, Ann Arbor, MI, USA; Department of Physical Medicine & Rehabilitation, University of Michigan, USA
| | - Nadia Vann
- Michigan Scleroderma Program, University of Michigan, Ann Arbor, MI, USA
| | - Francesco Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Leeds Biomedical Research Centre, National Institute for Health Research, Leeds, UK
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 Michigan Ave, 21st Floor, Chicago, IL, 60611, USA
| | - Maya H Buch
- Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.; NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Foundation Trust, Manchester, UK
| | - Dinesh Khanna
- Michigan Scleroderma Program, University of Michigan, Ann Arbor, MI, USA; Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
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Koleck TA, Topaz M, Tatonetti NP, George M, Miaskowski C, Smaldone A, Bakken S. Characterizing shared and distinct symptom clusters in common chronic conditions through natural language processing of nursing notes. Res Nurs Health 2021; 44:906-919. [PMID: 34637147 PMCID: PMC8641786 DOI: 10.1002/nur.22190] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 01/08/2023]
Abstract
Data-driven characterization of symptom clusters in chronic conditions is essential for shared cluster detection and physiological mechanism discovery. This study aims to computationally describe symptom documentation from electronic nursing notes and compare symptom clusters among patients diagnosed with four chronic conditions-chronic obstructive pulmonary disease (COPD), heart failure, type 2 diabetes mellitus, and cancer. Nursing notes (N = 504,395; 133,977 patients) were obtained for the 2016 calendar year from a single medical center. We used NimbleMiner, a natural language processing application, to identify the presence of 56 symptoms. We calculated symptom documentation prevalence by note and patient for the corpus. Then, we visually compared documentation for a subset of patients (N = 22,657) diagnosed with COPD (n = 3339), heart failure (n = 6587), diabetes (n = 12,139), and cancer (n = 7269) and conducted multiple correspondence analysis and hierarchical clustering to discover underlying groups of patients who have similar symptom profiles (i.e., symptom clusters) for each condition. As expected, pain was the most frequently documented symptom. All conditions had a group of patients characterized by no symptoms. Shared clusters included cardiovascular symptoms for heart failure and diabetes; pain and other symptoms for COPD, diabetes, and cancer; and a newly-identified cognitive and neurological symptom cluster for heart failure, diabetes, and cancer. Cancer (gastrointestinal symptoms and fatigue) and COPD (mental health symptoms) each contained a unique cluster. In summary, we report both shared and distinct, as well as established and novel, symptom clusters across chronic conditions. Findings support the use of electronic health record-derived notes and NLP methods to study symptoms and symptom clusters to advance symptom science.
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Affiliation(s)
- Theresa A. Koleck
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maxim Topaz
- School of Nursing, Columbia University, New York, New York
- Data Science Institute, Columbia University, New York, New York
| | - Nicholas P. Tatonetti
- Data Science Institute, Columbia University, New York, New York
- Department of Biomedical Informatics, Columbia University, New York, New York
- Department of Systems Biology, Columbia University, New York, New York
- Department of Medicine, Columbia University, New York, New York
- Institute for Genomic Medicine, Columbia University, New York, New York
| | - Maureen George
- School of Nursing, Columbia University, New York, New York
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco, San Francisco, California
| | - Arlene Smaldone
- School of Nursing, Columbia University, New York, New York
- College of Dental Medicine, Columbia University, New York, New York
| | - Suzanne Bakken
- School of Nursing, Columbia University, New York, New York
- Data Science Institute, Columbia University, New York, New York
- Department of Biomedical Informatics, Columbia University, New York, New York
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Patti M, Christian R, Palokas M. Association between anti-thyroid antibodies and quality of life in patients with Hashimoto thyroiditis: a systematic review and meta-analysis. JBI Evid Synth 2021; 19:2307-2338. [PMID: 33741837 DOI: 10.11124/jbies-20-00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this review was to evaluate the association between anti-thyroid antibodies and quality of life in people with euthyroid Hashimoto thyroiditis. INTRODUCTION Patients with Hashimoto thyroiditis report symptom distress more often than those with non-autoimmune thyroid disorders. Therefore, anti-thyroid antibodies may be related to decreased quality of life in persons with Hashimoto thyroiditis. The etiology of lingering symptoms, even in euthyroidism, remains unknown. The relationship between anti-thyroid antibodies and quality of life for people with Hashimoto thyroiditis has not been evaluated in a systematic review. INCLUSION CRITERIA The participants were males and females at least 12 years of age, in any country, with Hashimoto thyroiditis. Participants not in a euthyroid state were excluded from this review. In this review, the exposure was the presence of anti-thyroid antibodies and the primary outcome was quality of life as measured by a validated scale. METHODS A three-step search strategy was implemented with an initial search of PubMed and CINAHL. A comprehensive database search using all identified keywords and index terms was undertaken in March 2019 for relevant published literature, gray literature, and clinical trial registries. The final updates to the search strategies were conducted in December 2019. The search was limited to studies published in English after 1956. Two independent reviewers completed screening for inclusion and utilized the recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis. The findings are presented in a meta-analysis and in a narrative synthesis, which includes tables and figures. RESULTS All 13 studies had high methodological quality. Four studies found a significant correlation (P < 0.05) between the presence of anti-thyroid antibodies and quality of life. A fifth study found a significant correlation (P < 0.001) between higher antibody levels and quality of life. A meta-analysis was conducted using two cross-sectional studies, which revealed that the summative small effect size was statistically significant and suggested a lower quality of life in antibody-positive patients. Due to the heterogeneity of the studies, a narrative synthesis was conducted for the three secondary outcomes: symptom distress, executive function, and mental health. Three studies found a statistically significant (P < 0.05) correlation between symptom distress and antibodies, two studies found a statistically significant (P < 0.05) association between executive function and antibodies, and all but one study found a statistically significant (P < 0.05) relationship between mental health and antibodies. CONCLUSIONS The findings in this review did not reveal a definitive relationship between antibodies and quality of life. However, our meta-analysis suggested a link between anti-thyroid antibodies and decreased quality of life in euthyroid children and adults. Though not conclusive, poor mental health and symptom distress may be associated with anti-thyroid antibodies. Therefore, it may be beneficial to periodically evaluate the quality of life and mental health in euthyroid patients with positive antibodies. It is unlikely that antibodies and executive functions are related. The studies and our review's limitations require replication of findings to confirm a connection between antibodies, quality of life, and the secondary outcomes. Future research should continue to evaluate the relationship between anti-thyroid antibodies and the quality of life in individuals with euthyroid Hashimoto thyroiditis. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42018084663.
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Affiliation(s)
- Marion Patti
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Centre of Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
| | - Robin Christian
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Centre of Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
| | - Michelle Palokas
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Centre of Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
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Sreedhar J. Symptom Occurrence, Severity, and Self-Care Methods by Ethnicity and Age Group Among Adults With Cancer. Oncol Nurs Forum 2021; 48:522-534. [PMID: 34411086 DOI: 10.1188/21.onf.522-534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the relationships among cancer therapy-related symptom occurrence and severity, selected cancer-related variables, and demographic variables. Secondary purposes were to examine participants' reported symptom occurrence and severity by ethnicity and by age group and to identify self-care methods. SAMPLE & SETTING Convenience sampling was used and included 110 adults receiving cancer treatment from a major hospital in the northeast region of the United States. METHODS & VARIABLES A descriptive correlational design was used. Study variables were symptom occurrence and severity and selected demographic and cancer-related variables. The Therapy-Related Symptom Checklist was used to measure symptom occurrence and severity, and the Symptom Alleviation. RESULTS Significant relationships were found between symptom occurrence and severity and gender, economic status, and disease stage. Feeling sluggish was the most frequently reported symptom. IMPLICATIONS FOR NURSING Oncology nurses are in an influential position to educate and manage participants' cancer therapy-related symptoms.
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Abstract
BACKGROUND Exposure to chronic stressors may contribute to the development of psychoneurological symptoms (i.e., fatigue, cognitive dysfunction, sleep disturbance, depressed mood, and pain) that can compromise maternal function. OBJECTIVES In two studies of low-income mothers, we investigated the presence of psychoneurological symptoms and explored associations between mothers' stressors and psychoneurological symptoms as well as between symptoms and function. We also considered the possible mediating role of the symptoms between stressors and function. METHODS We conducted secondary analyses of psychoneurological symptoms in two studies of low-income mothers of infants and toddlers in the United States. Study 1 sampled Latina women with limited English proficiency, whereas Study 2 was conducted with English-speaking women from diverse backgrounds. In both studies, symptoms were measured using items from the Center for Epidemiological Studies Depression Scale and the Medical Outcomes Study Short-Form Health Survey. Maternal function was measured through self-report and researcher observation. In Study 2, stressors were measured using the Everyday Stressors Index. Multiple linear regressions were used to investigate associations while controlling for relevant covariates. RESULTS In both studies, mothers endorsed a wide range of psychoneurological symptoms. In Study 1, psychoneurological symptoms had significant negative associations with role function, social function, and developmental stimulation. In Study 2, psychoneurological symptoms had significant negative associations with role function, social function, and physical function. Using Aroian test for mediation, we found that psychoneurological symptoms mediated all significant relationships between stressors and maternal functions in Study 2. DISCUSSION In two samples of low-income mothers, psychoneurological symptoms were prevalent and associated with chronic stressors and with maternal function and may mediate the association between those two factors. These findings extend prior research on depressive symptoms in mothers by investigating pain as an additional key symptom. The studies advance symptom science by highlighting psychoneurological symptoms in a heterogeneous sample without known health conditions.
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Silva-Rodrigues FM, de Lucca M, Leite ACAB, Alvarenga WDA, Nunes MDR, Nascimento LC. Management of chemotherapy-related symptoms in children and adolescents: family caregivers' perspectives. Rev Esc Enferm USP 2021; 55:e20200484. [PMID: 34423804 DOI: 10.1590/1980-220x-reeusp-2020-0484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/09/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the chemotherapy-associated symptoms and the strategies used for their management from the perspective of pediatric cancer patients' family caregivers. METHODS This is a descriptive study with qualitative data analysis. Data collection took place in a pediatric hospital, from December 2017 to December 2018, with family caregivers of pediatric patients undergoing chemotherapy. Semi-structured interviews, subjected to inductive content analysis, were carried out. Concepts from the Symptom Management Theory were used to discuss the results. RESULTS Eighteen family caregivers participated. The participants mentioned: physical symptoms, especially weakness, alopecia, low immunity, pain, mucositis, constipation, nausea, and vomiting; emotional or psychosocial symptoms such as sadness and mood changes; and constitutional symptoms such as loss of appetite and fever. Pharmacological and non-pharmacological measures were mentioned in the management of symptoms and adverse effects. CONCLUSION Participants demonstrated skills to identify and manage symptoms of chemotherapy. Knowing the experience of these families can help nurses in planning care and interventions to minimize these events.
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Affiliation(s)
| | - Milena de Lucca
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Thontham A, Polsook R. Symptom experience of adverse drug reaction among male and female patients with newly diagnosed pulmonary tuberculosis in Thailand. BELITUNG NURSING JOURNAL 2021; 7:195-202. [PMID: 37469342 PMCID: PMC10353636 DOI: 10.33546/bnj.1337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/07/2021] [Accepted: 05/10/2021] [Indexed: 07/21/2023] Open
Abstract
Background Patients with newly diagnosed pulmonary tuberculosis often suffer from adverse drug reaction symptoms, which leads to the automatic discontinuation of anti-tuberculosis drugs. Thus, understanding symptom experience of adverse drug reactions is necessary. Objective This study aimed to examine differences in symptoms experienced in four dimensions: presence, frequency, severity, and distress of adverse drug reactions, between male and female patients. Methods This was a quantitative survey with a cross-sectional design, with data collected between January and April 2020. A total of 394 patients with newly diagnosed pulmonary tuberculosis was selected through a purposive sampling technique. The symptom experiences of adverse drug reactions were measured using a validated instrument. Data were analyzed using mean, standard deviation, and independent t-test. Results The most commonly reported symptom was itchiness (24.1% in males and 34.9% in females). Vomiting occurred as the most frequent symptom among males (x̄ ± SD = 2.73 ± .88), and fatigue was found to be the most severe and distressing symptom across male patients (x̄ ± SD = 2.50 ± 1.61 and 2.06 ± 1.30, respectively). In contrast, yellowing of the eyes and skin was most frequent and severe among females (x̄ ± SD = 3.17 ± .75 and 3.83 ± 1.47, respectively). In addition, flu-like symptoms were evaluated as the most distressing symptom for female patients (x̄ ± SD = 2.80 ± 1.09). The symptom burdens of the females ranged significantly and reached higher than those of the male patients at a p-value of .05 (t = 3.33). Conclusion Females taking anti-tuberculosis drugs should be carefully monitored to deal with adverse drug reaction symptoms. This finding would help to decrease the severity of disease and improve their quality of life.
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Affiliation(s)
| | - Rapin Polsook
- Corresponding author: Assistant Professor Police Captain Rapin Polsook, PhD, RN, Faculty of Nursing, Chulalongkorn University, Boromarajonani Srisatapat Building, Rama1 Rd, Floor 11 Patumwan, Bangkok 10330, Thailand. Telephone: 66-22181151, Cell phone: 66-8183-2109-5. ;
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Koleck TA, Tatonetti NP, Bakken S, Mitha S, Henderson MM, George M, Miaskowski C, Smaldone A, Topaz M. Identifying Symptom Information in Clinical Notes Using Natural Language Processing. Nurs Res 2021; 70:173-183. [PMID: 33196504 PMCID: PMC9109773 DOI: 10.1097/nnr.0000000000000488] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Symptoms are a core concept of nursing interest. Large-scale secondary data reuse of notes in electronic health records (EHRs) has the potential to increase the quantity and quality of symptom research. However, the symptom language used in clinical notes is complex. A need exists for methods designed specifically to identify and study symptom information from EHR notes. OBJECTIVES We aim to describe a method that combines standardized vocabularies, clinical expertise, and natural language processing to generate comprehensive symptom vocabularies and identify symptom information in EHR notes. We piloted this method with five diverse symptom concepts: constipation, depressed mood, disturbed sleep, fatigue, and palpitations. METHODS First, we obtained synonym lists for each pilot symptom concept from the Unified Medical Language System. Then, we used two large bodies of text (clinical notes from Columbia University Irving Medical Center and PubMed abstracts containing Medical Subject Headings or key words related to the pilot symptoms) to further expand our initial vocabulary of synonyms for each pilot symptom concept. We used NimbleMiner, an open-source natural language processing tool, to accomplish these tasks and evaluated NimbleMiner symptom identification performance by comparison to a manually annotated set of nurse- and physician-authored common EHR note types. RESULTS Compared to the baseline Unified Medical Language System synonym lists, we identified up to 11 times more additional synonym words or expressions, including abbreviations, misspellings, and unique multiword combinations, for each symptom concept. Natural language processing system symptom identification performance was excellent. DISCUSSION Using our comprehensive symptom vocabularies and NimbleMiner to label symptoms in clinical notes produced excellent performance metrics. The ability to extract symptom information from EHR notes in an accurate and scalable manner has the potential to greatly facilitate symptom science research.
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Tabudlo JB. A Proposed Theory of Symptom Cluster Management. BELITUNG NURSING JOURNAL 2021; 7:78-87. [PMID: 37469941 PMCID: PMC10353591 DOI: 10.33546/bnj.1359] [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] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/11/2021] [Accepted: 04/13/2021] [Indexed: 07/21/2023] Open
Abstract
Background Symptom cluster management is in its early stages in many chronic and debilitating illnesses. The development of a proposed theory should be an initial step in advancing this area of interest. Objective This article presents the development of a Proposed Theory of Symptom Cluster Management. Methods The concept analysis, statement synthesis, and theory synthesis by Walker and Avant were used in the development of this proposed theory. A search from July to September 2020 for published empirical and theoretical articles was conducted in scientific databases, expanded on the web, and secondary references from identified articles. Results The Proposed Theory of Symptom Cluster Management is both a descriptive and explanatory theory. The defining characteristics of symptom cluster management include the basic and effectiveness components. Antecedents for symptom cluster management include socio-demographic characteristics, symptom cluster characteristics, individual clinical characteristics, individual illness factors, and situational factors or symptom experience. The consequences are clustered as personal-related, health-related, social-related outcomes, and existential outcomes. Measurement tools for the antecedents and outcomes in symptom cluster management and the analytical and statistical strategies were considered. Relational statements were also identified. Theoretical assertions were advanced. Conclusion The Proposed Theory of Symptom Cluster Management may provide a holistic approach because it integrates both the symptom cluster and management strategies. The concepts, statements including the complete representation of the proposed theory identified in this article, may provide cues to policymakers and clinical researchers towards the development of tailored interventions and programs.
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Affiliation(s)
- Jerick B. Tabudlo
- University of the Philippines Manila, College of Nursing, Philippines
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Examining the Relationship Between Patient Fatigue-Related Symptom Clusters and Carer Depressive Symptoms in Advanced Cancer Dyads: A Secondary Analysis of a Large Hospice Data Set. Cancer Nurs 2021; 43:498-505. [PMID: 31361674 DOI: 10.1097/ncc.0000000000000737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Most symptom management takes place in the community, conducted by patient and/or informal carer dyads with guidance from clinicians. Given the prevalence of cancer, there is a critical need for examination of the impact of managing multiple symptoms, particularly those that cluster with fatigue, on informal carers. OBJECTIVES To (1) examine clustering of patient fatigue-related symptom severity and distress in individuals with cancer and (2) test the hypothesis that patient fatigue-related symptom clusters (severity, distress) will be positively associated with carer depressive symptoms. METHODS Secondary analysis of 689 hospice patient/informal carer dyads using exploratory factor analysis and structural equation modeling. Patient symptoms were measured by the Memorial Symptom Assessment Scale, and carer depressive symptoms were measured by the Center for Epidemiological Study-Depression Scale. RESULTS Patients were 73 (SD, 12) years old, and 43% were female. Carers were 65 years (SD, 14) years old, and 74% were female. For symptom severity, dyspnea, dry mouth, lack of appetite, drowsiness, cough, dizziness, and difficulty swallowing clustered with fatigue. For symptom distress, dyspnea, cough, and dry mouth clustered with fatigue. Structural equation modeling results indicated that the patient fatigue severity cluster was positively related to carer depressive symptoms (b = 0.12, P < .05), but distress was not. CONCLUSION Managing multiple symptoms that cluster with fatigue negatively impacts informal carers. IMPLICATIONS FOR PRACTICE When patients complain of severe fatigue, clinicians need to explore all causes and ask about other symptoms while exploring whether the informal carer is feeling burdened or depressed.
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Ellis KR, Oh S, Hecht HK, Northouse L. Symptom distress and quality of life among Black Americans with cancer and their family caregivers. Psychooncology 2021; 30:1356-1365. [PMID: 33861891 DOI: 10.1002/pon.5691] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Black Americans are disproportionately affected by cancer and chronic diseases. Black patients with cancer and their family caregivers may concurrently experience symptoms that influence their wellbeing. This study investigates the influence of mental and physical symptom distress on quality of life (QOL) among Black Americans with cancer and their family caregivers from a dyadic perspective. METHODS One hundred and fifty-one dyads comprised of a Black American with breast, colorectal, lung or prostate cancer and a Black family caregiver were included in this secondary analysis of pooled baseline data from three studies. Self-reports of problems managing 13 symptoms were used to measure mental and physical symptom distress. Descriptive statistics and the actor-partner interdependence model were used to examine symptom prevalence and the influence of each person's symptom distress on their own and each other's QOL. RESULTS Fatigue, sleep problems, pain and mental distress were prevalent. Patients and caregivers reported similar levels of mental distress; however, patients reported higher physical distress. Increased patient mental distress was associated with decreased patient QOL (overall, emotional, social, functional). Increased patient physical distress was associated with decreased patient QOL (overall, physical, emotional, functional) and decreased caregiver emotional wellbeing. Increased caregiver mental distress was associated with decreased caregiver QOL (overall, emotional, social, functional) and decreased patient overall QOL. Increased caregiver physical distress was associated with decreased caregiver QOL (overall, physical, functional), decreased patient emotional wellbeing, and better patient social wellbeing. CONCLUSIONS Supporting symptom management in Black patient/caregiver dyads may improve their QOL.
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Affiliation(s)
- Katrina R Ellis
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Seyoung Oh
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Hillary K Hecht
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laurel Northouse
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Fei F, Koffman J, Zhang X, Gao W. Chronic Obstructive Pulmonary Disease Symptom Cluster Composition, Associated Factors, and Methodologies: A Systematic Review. West J Nurs Res 2021; 44:395-415. [PMID: 33682534 PMCID: PMC8894625 DOI: 10.1177/0193945921995773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This systematic review details symptom clusters, their compositions, and associated factors and appraises the methodologies of studies that reported symptom clusters in patients with chronic obstructive pulmonary disease (COPD). Ten studies were eligible for inclusion in this study. Four common symptom clusters were identified. Two theoretical frameworks, four statistical methods, and various symptom assessment tools were used to identify symptom clusters. Factors associated with symptom clusters included demographic, clinical, and biological factors. No studies examined the subjective experiences of symptom clusters. Overall, inconsistencies were identified in the composition of symptom clusters across studies. This may be due to variations in study design, assessment tools, and statistical methods. Future studies should attempt to arrive at a common definition, especially that is theoretically derived, for symptom clusters, standardize the criteria for symptoms for inclusion in the clusters, and focus on patients' subjective experience to inform which clusters are clinically relevant.
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Affiliation(s)
- Fei Fei
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.,School of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, Jiangsu, P.R. China
| | - Jonathan Koffman
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Xiaohan Zhang
- School of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, Jiangsu, P.R. China
| | - Wei Gao
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Du R, Wang X, Ma L, Larcher LM, Tang H, Zhou H, Chen C, Wang T. Adverse reactions of targeted therapy in cancer patients: a retrospective study of hospital medical data in China. BMC Cancer 2021; 21:206. [PMID: 33639888 PMCID: PMC7916285 DOI: 10.1186/s12885-021-07946-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. METHODS A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. RESULTS A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. CONCLUSION The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.
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Affiliation(s)
- Ruofei Du
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
- School of Medical Sciences, Zhengzhou University, Zhengzhou, 450001 China
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Lixia Ma
- School of Statistics, Henan University of Economics and Law, Zhengzhou, 450046 China
| | - Leon M. Larcher
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| | - Han Tang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Huiyue Zhou
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
- Hebi People’s Hospital, Hebi, 458030 China
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Abstract
BACKGROUND Patients with end-stage renal disease receiving dialysis experience a significant symptom burden. Identifying factors associated with this burden may improve symptom management. However, specific evidence about patients' experiences is lacking. OBJECTIVES The aim of this study was to explore factors that are associated with patients' symptom experiences. METHODS The convergent parallel mixed methods design was used. In the quantitative component, the Dialysis Symptom Index was used to assess the symptom burden of 271 participants to examine its associations with patient characteristics using correlation coefficients and multivariate regression analyses. In the qualitative component, associated factors reported by 10 participants were identified through semistructured interviews using content analysis. Assessments were conducted at enrollment, 6 months, and 12 months. After separate data analyses, findings were integrated using side-by-side comparison and joint display. RESULTS Several significant associations were identified between patient characteristics and symptom burden, and the participants described four categories of factors (i.e., treatment related, pathophysiological, situational, dietary) associated with a higher symptom burden during their interviews. Across both components of this study, three factors were consistent (i.e., employment, hyperphosphatemia, anemia). Participants described several factors not reported previously. DISCUSSION This study explored subjective and objective factors influencing the symptom experiences of patients with end-stage renal disease using a mixed methods design. These risk factors can be used to identify high-risk patients. Our findings suggest that participants relied on laboratory results and treatments to explain their symptom experiences. These findings suggest that assessment of both subjective and objective factors is needed to explore patients' symptom experiences.
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Chien TW, Lai CY, Huang SS, Tsai LY, Tsai MC, Tsay SL. Cancer pain and lower functional status predict poor trajectories of symptom and fatigue distress in patients with lung cancer. Eur J Cancer Care (Engl) 2021; 30:e13403. [PMID: 33484044 DOI: 10.1111/ecc.13403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/05/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To identify distinct subgroups of patients newly diagnosed with lung cancer (LC) over time and to explore the predictors of distinct trajectories of symptom and fatigue distress in LC patients. METHODS A total of 120 patients newly diagnosed with LC were recruited in this longitudinal prospective study. Our survey investigated patients' symptoms in 6 months. Latent growth curve analysis (LGCA) was conducted to identify patients with distinct trajectories of symptom and fatigue distress. The characteristics of the patients among groups were compared for statistical differences by the chi-square test or ANOVA. RESULTS The results of LGCA revealed that the linear three-trajectory model had the best model fit for symptom and fatigue distress. Patients' symptom and fatigue distress improved with time, except for patients with increasing trajectories. Patients' trajectories of symptom and fatigue distress were affected by pain, lower functional status, total symptom score and depression. Moreover, patients with increasing trajectories of symptom and fatigue distress experienced more pain, physiological symptoms and depression from 1 to 6 months. CONCLUSIONS Pain and functional status were the major factors that deteriorated the recovery of trajectory in symptom distress and fatigue distress among patients with increasing trajectories.
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Affiliation(s)
- Tsui-Wei Chien
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chung-Yu Lai
- Surgery Department, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan.,College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Sheng-Shiung Huang
- College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Li-Yun Tsai
- College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Meng-Chuan Tsai
- Department of Sport and Health Management, Da-Yeh University, Changhua, Taiwan
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
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Abstract
Delirium is a manifestation of brain injury or acute and generalized dysfunction of the upper cerebral cortical processes. In this way, it is important to analyze delirium more broadly as a symptom to understand and intervene taking into account that it is manifesting the presence of brain lesions whose consequences are deleterious to the neurological performance of patients. This article is intended to present a comprehensive approach of delirium analyzed from a symptom perspective and from theoretical and conceptual structure, such as the Dynamic Symptoms Model, specific to the nursing practice. A literature review related to delirium and components of Dynamic Symptoms Model was carried out. We searched the MEDLINE, ScienceDirect, SciELO, and Scopus databases using the terms Delirium, Intensive Care Units, Nursing, and Risk Factor. The existing literature provides evidence of the antecedents, experience, interventions, interactions, and consequences of delirium, which are components of the Model. Thus, the analysis from the Dynamic Symptoms Model perspective bears relevance and contributes to the understanding and approach of delirium.
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Tsehay M, Belete A, Necho M. Factors Associated with Psychological Distress and Brief Resilient Coping Level During the COVID-19 Pandemic Among Health-Care Professionals in Dessie, Ethiopia. Psychol Res Behav Manag 2020; 13:1213-1221. [PMID: 33364863 PMCID: PMC7751773 DOI: 10.2147/prbm.s288562] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/07/2020] [Indexed: 01/15/2023] Open
Abstract
Background The outbreak of Coronavirus Disease 2019 (COVID-19) has caused serious threats to people’s health and lives in the world. The health-care professionals are bravely fighting on the front lines of the pandemic everywhere in the world. Our study is the first to study psychological distress and coping status among health-care professionals of Dessie town, Ethiopia during the unbridled time of the COVID-19 outbreak. Methods A cross-sectional internet-based study was conducted between June 20 and July 13, 2020. The questionnaires included the demographic information, COVID-19 related questions, Kasseler-10 to assess psychological distress level and Brief Resilient Coping Scale, and Oslo-3 social support scale questionnaire were employed. Results A total of 423 participants were involved in the study with a response rate of 100%. The mean age of respondents was 34.5 years (SD = ±8.45 years). The prevalence of psychological distress among participants was 42%. Of these 18%, 11%, and 13% had mild, moderate, and severe psychological distress levels. Being married, being nurses and pharmacies, current substance users, working in emergency and outpatient departments, history of chronic medical illness, brief resilient coping level, and social support level were particularly associated with high psychological distress. Conclusion Health-care professionals are experiencing a substantial level of psychological distress. In addition to other modifying factors coping level and social support was a significant predictor of psychological distress among health-care professionals. These findings should inform the implementation of interventions that increase coping resilience and social support to mitigate the impact of psychological distress among health-care professionals.
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Affiliation(s)
- Mekonnen Tsehay
- Wollo University, College of Medicine and Health Science, Department of Psychiatry, South Wollo, Dessie, Ethiopia
| | - Asmare Belete
- Wollo University, College of Medicine and Health Science, Department of Psychiatry, South Wollo, Dessie, Ethiopia
| | - Mogesie Necho
- Wollo University, College of Medicine and Health Science, Department of Psychiatry, South Wollo, Dessie, Ethiopia
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Chen X, Zhang Y, Yu J. Symptom Experience and Related Predictors in Liver Transplantation Recipients. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 15:8-14. [PMID: 33188944 DOI: 10.1016/j.anr.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/25/2020] [Accepted: 11/08/2020] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Symptom experience after liver transplantation (LT) provides healthcare professionals with important information about the benefits and limitations of LT from patients' perspective. This study aims to explore the multidimensional symptom experience and analyze related predictive factors in LT recipients. METHODS This cross-sectional study evaluated the occurrence, frequency, intensity, and level of distress of 40 symptoms in 265 LT recipients. Stepwise multiple regression analysis was performed to analyze the influencing factors of symptom experience. RESULTS The analysis of patient-reported data indicated that the ten most common symptoms were fatigue (42.3%), frequent sleep interruptions (38.9%), difficulty falling asleep (35.9%), decreased memory (34.0%), dreaminess (29.8%), itch (28.7%), muscular weakness (26.4%), shortness of breath (25.3%), anxiety (24.5%), and hand tremor (21.9%). Patients were classified into four groups according to survival time (1-month, 2-6-month, 7-12-month, and >1-year groups) after LT, and the most common symptom was fatigue in the one-month and 2-6-month groups, difficulty falling asleep in the 7-12-month group, and decreased memory in the >1-year group. Type of the primary caregiver, complications, concerns about the decreased ability to perform household and outdoor activities, and concerns about being a burden to the family were predictors of symptoms burden. CONCLUSION LT recipients experienced complicated symptoms. In clinical practice, it is critical to integrate physicians, nurses, and social workers as a medical team to help LT recipients develop suitable coping strategies that can potentially address patients' concerns, increase the sense of confidence, and improve symptom outcomes.
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Affiliation(s)
- Xiao Chen
- Liver Disease Department, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Yuxia Zhang
- Nursing Department, Zhongshan Hospital of Fudan University, Shanghai, China.
| | - Jingxian Yu
- Liver Disease Department, Zhongshan Hospital of Fudan University, Shanghai, China
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What symptoms tell us: A multiple case study of oncology consultations. Palliat Support Care 2020; 19:421-436. [PMID: 32912373 DOI: 10.1017/s1478951520000899] [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: 11/07/2022]
Abstract
OBJECTIVES While patients' symptom experiences have been widely investigated, there is a lack of contextualized studies investigating how symptoms circulate in the medical consultation, how patients present them, what they convey, how physicians respond, and how patients and physicians negotiate with each other to find ways to address them. The aim of this study is to explore patients and physicians handling of symptoms throughout oncological consultations with a multiple case study approach. METHODS Five consultations, purposively selected from an existing dataset of audiotaped consultations with patients with advanced cancer, were analyzed by means of an inductive analytical approach based on a sensitive framework from the literature. RESULTS Patients' symptoms showed multiple dimensions such as medical, cognitive, emotional, psychological, interactional, symbolic, experiential, and existential. SIGNIFICANCE OF RESULTS Different symptom dimensions remained unnoticed and unaddressed in the consultations. The physician-centered symptom approach that was observed leads to consumed time and missed opportunities for relationship building with the patient. Physicians showed a lack of sensitivity regarding the multiple dimensions of symptoms. Based on the findings, strategies for a more comprehensive symptom approach can be conceived.
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Abstract
The Middle-Range Theory of Self-Care of Chronic Illness has been used widely since it was first published in 2012. With the goal of theoretical refinement in mind, we evaluated the theory to identify areas where the theory lacked clarity and could be improved. The concept of self-care monitoring was determined to be underdeveloped. We do not yet know how the process of symptom monitoring influences the symptom appraisal process. Also, the manner in which self-care monitoring and self-care management are associated was thought to need refinement. As both of these issues relate to symptoms, we decided to enrich the Middle-Range Theory with knowledge from theories about symptoms. Here, we propose a revision to the Middle-Range Theory of Self-Care of Chronic Illness where symptoms are clearly integrated with the self-care behaviors of self-care maintenance, monitoring, and management.
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Berkowitz MJ, Thompson CK, Zibecchi LT, Lee MK, Streja E, Berkowitz JS, Wenziger CM, Baker JL, DiNome ML, Attai DJ. How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support. J Cancer Surviv 2020; 15:29-39. [PMID: 32804353 PMCID: PMC7430212 DOI: 10.1007/s11764-020-00908-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/14/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Many patients with hormone receptor-positive (HR+) breast cancer do not adhere to endocrine therapy (ET), and treatment-related side effects are often discussed by participants in online breast cancer forums. Our aim was to survey this unique group of patients about their ET-related experiences. METHODS We partnered with patients active in breast cancer social media communities to develop a survey assessing ET-related side effects and medical team communication. Patients with a history of HR+ breast cancer who had received a recommendation to take ET were eligible to participate in the anonymous, online survey. RESULTS Respondents included 2353 women and 54 men. Aromatase inhibitors were the most commonly used medication. Side effects were reported by 91.2%, were more often experienced by women than men (p < 0.001), and were primarily related to medication type. Approximately one-third of respondents discontinued therapy early. While most felt supported by their medical team, 31.5% reported that their side effects were dismissed or minimized. Survey respondents most frequently reported that a healthy diet and exercise, yoga/acupuncture, and vitamins/supplements were helpful in managing ET-related side effects. CONCLUSIONS ET-related side effects are very common, and one-third discontinued treatment early. Lifestyle changes and complementary therapies can be important tools for side effect management. One-third of patients did not feel that their side effects were taken seriously. IMPLICATIONS FOR CANCER SURVIVORS This is the largest survey of ET use by participants in online breast cancer communities. Further research is needed to identify strategies to improve treatment adherence and to better manage ET-related side effects.
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Affiliation(s)
- Maurice J Berkowitz
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Carlie K Thompson
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Laura T Zibecchi
- Department of Nursing, University of California Los Angeles, Los Angeles, USA
| | - Minna K Lee
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Elani Streja
- Department of Medicine, University of California Irvine School of Medicine, Irvine, USA
| | - Jacob S Berkowitz
- Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, USA
| | - Cachet M Wenziger
- Department of Medicine, University of California Irvine School of Medicine, Irvine, USA
| | - Jennifer L Baker
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Maggie L DiNome
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Deanna J Attai
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
- UCLA Health Burbank Breast Care, 191 S. Buena Vista #415, Burbank, CA, 91505, USA.
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MacKrill K, Groom KM, Petrie KJ. The effect of symptom-tracking apps on symptom reporting. Br J Health Psychol 2020; 25:1074-1085. [PMID: 32790051 DOI: 10.1111/bjhp.12459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The use of health apps is increasing worldwide, with a common feature being daily symptom tracking. However, symptom tracking has been shown to increase symptom reporting. This study investigated whether using a menstrual-monitoring app with a symptom-tracking feature increases symptom reporting compared to an app without this feature or no app at all. DESIGN Experimental study. METHODS Ninety-one participants were randomly allocated to use either a menstrual-monitoring app with a symptom tracker or a simple calendar app, or to a no app control group. The number of period-related symptoms as well as general symptom reporting was assessed at baseline prior to group allocation and then 1 and 4 months later. The change in the proportion of people classified as high symptom reporters was also examined. RESULTS We found that the symptom-tracking app group reported significantly more period-related symptoms at 4 months than the calendar app group (mean difference = 1.16 symptoms, p = .010). At the 4-month time point, significantly more participants in the symptom-tracking group were now classified as high period symptom reporters (baseline 50%, 4 months 70%, p = .031), while the other two groups did not change from baseline. There were no differences in general symptom reporting across the three groups. CONCLUSION A period-monitoring app with a symptom tracker may increase the reporting of period symptoms. This effect does not appear to generalize to broader symptom reporting. Further research is needed to support these findings and to examine the impact of symptom-tracking apps on daily functioning and health anxiety. Statement of contribution What is already known on this subject? The experience of transient symptoms is common in day-to-day life. These symptoms often do not have an underlying cause or are a sign of illness. Actively tracking symptoms has been shown to result in greater symptom reporting, symptom severity, and slower recovery from injury. The use of health apps is increasing, with a common feature being symptom tracking. Menstrual-monitoring apps, in particular, frequently require users to track symptoms. What does this study add? Using a menstrual-monitoring app with a symptom tracker for 4 months increases the number of period-specific symptoms reported compared a basic calendar app. A greater proportion of people were now classified as high period symptom reporters after using the symptom-tracking app. These effects do not seem to generalize to broader non-specific symptom reporting.
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Affiliation(s)
- Kate MacKrill
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Katie M Groom
- Liggins Institute, University of Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, University of Auckland, New Zealand
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Ang WHD, Lau Y, Ngo LPE, Siew AL, Ang NKE, Lopez V. Path analysis of survivorship care needs, symptom experience, and quality of life among multiethnic cancer survivors. Support Care Cancer 2020; 29:1433-1441. [PMID: 32676855 DOI: 10.1007/s00520-020-05631-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/13/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Cancer survivors continue to experience issues that persist across the survivorship trajectory. This study aims to explore the relationship among survivorship care need, symptom experience, and quality of life (QoL) of multiethnic cancer survivors by using path analytic methods. METHODS Participants were recruited from an academic medical center in Singapore that provides inpatient and outpatient oncology and hematology service. The Cancer Survivor Unmet Needs measure, physical effects subscale of the Cancer Survivors' Survey of Needs tool, and a Global QoL 10-point Likert scale were used to identify survivorship care needs, symptom experience, and QoL. Descriptive statistics were used to compute sociodemographic information, total survivorship needs, symptom experienced, and quality of life scores. The symptom experience model was used as the hypothetical model. The Analysis of Moment Structure was used to conduct the path analysis to evaluate the relationship between survivorship care needs, symptom experience, and quality of life. RESULTS Older cancer survivors were more likely to have spent a longer duration having cancer. Males were unlikely to suffer from solid tumor malignancies. Survivors with solid tumor malignancies were less likely to require supportive care. Survivors who require more supportive care were more likely to have a greater symptom burden. Cancer survivors with more symptoms have poorer QoL. The findings from this study partially supported the symptom experience model. CONCLUSIONS Our findings reveal that cancer survivors continue to experience symptoms across the survivorship trajectory. The results provide information for nurses during the planning and execution of survivorship care.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Lay Poh Ednajoy Ngo
- Division of Oncology Nursing, National University Cancer Institute, Singapore, Singapore
| | - An Ling Siew
- Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Neo Kim Emily Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Nursing, National University Health System, Singapore, Singapore
| | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei Province, People's Republic of China
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Tripp-Reimer T, Williams JK, Gardner SE, Rakel B, Herr K, McCarthy AM, Hand LL, Gilbertson-White S, Cherwin C. An integrated model of multimorbidity and symptom science. Nurs Outlook 2020; 68:430-439. [PMID: 32482344 PMCID: PMC7483649 DOI: 10.1016/j.outlook.2020.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/13/2020] [Accepted: 03/21/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Prevalence and complexity of persons with multiple chronic conditions (MCC), also known as multimorbidity, are shifting clinical practice from a single disease focus to one considering MCC and symptoms. Although symptoms are intricately bound to concepts inherent in MCC science, symptoms are largely ignored in multimorbidity research and literature. PURPOSE Introduce an Integrated Model of Multimorbidity and Symptom Science. METHODS Critical integrative review and synthesis process. FINDINGS The model comprises three primary domains: 1. Contributing/ Risk Factors; 2. Symptom/Disease/Treatment Interactions; and 3. Patient Outcomes. DISCUSSION The model highlights the multilevel nature of contributing factors and the recursive interactions among multiple etiologies, conditions, symptoms, therapies, and outcomes.
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Affiliation(s)
| | | | - Sue E Gardner
- College of Nursing, The University of Iowa, Iowa City, IA
| | - Barbara Rakel
- College of Nursing, The University of Iowa, Iowa City, IA
| | - Keela Herr
- College of Nursing, The University of Iowa, Iowa City, IA
| | | | - Linda Liu Hand
- College of Nursing, The University of Iowa, Iowa City, IA
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Salomon RE, Crandell J, Muscatell KA, Santos HP, Anderson RA, Beeber LS. Two Methods for Calculating Symptom Cluster Scores. Nurs Res 2020; 69:133-141. [PMID: 31804434 DOI: 10.1097/nnr.0000000000000412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Symptom clusters are conventionally distilled into a single score using composite scoring, which is based on the mathematical assumption that all symptoms are equivalently related to outcomes of interest; this may lead to a loss of important variation in the data. OBJECTIVES This article compares two ways of calculating a single score for a symptom cluster: a conventional, hypothesis-driven composite score versus a data-driven, reduced rank regression score that weights the symptoms based on their individual relationships with key outcomes. METHODS We conducted a secondary analysis of psychoneurological symptoms from a sample of 356 low-income mothers. Four of the psychoneurological symptoms (fatigue, cognitive dysfunction, sleep disturbance, and depressed mood) were measured with the Center for Epidemiological Studies Depression Scale; the fifth (pain) was measured using an item from the Medical Outcomes Study 12-item Short Form Health Survey (SF-12). Mothers' function was measured using the 12-item Short Form Health Survey. The composite score was calculated by summing standardized scores for each individual psychoneurological symptom. In contrast, reduced rank regression weighted the individual symptoms using their respective associations with mothers' function; the weighted individual symptom scores were summed into the reduced rank regression symptom score. RESULTS The composite score and reduced rank regression score were highly correlated at .93. The cluster of psychoneurological symptoms accounted for 53.7% of the variation in the mothers' function. Depressed mood and pain accounted for almost all the explained variation in mothers' function at 37.2% and 15.0%, respectively. DISCUSSION The composite score approach was simpler to calculate, and the high correlation with the reduced rank regression score indicates that the composite score reflected most of the variation explained by the reduced rank regression approach in this data set. However, the reduced rank regression analysis provided additional information by identifying pain and depressed mood as having the strongest association with a mother's function, which has implications for understanding which symptoms to target in future interventions. Future studies should also explore composite versus reduced rank regression approaches given that reduced rank regression may yield different insights in other data sets.
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Affiliation(s)
- Rebecca E Salomon
- Rebecca E. Salomon, PhD, RN, PMHNP-BC, is Postdoctoral Fellow, University of California San Francisco School of Nursing. At the time this research was completed, she was a Predoctoral Trainee at the University of North Carolina at Chapel Hill School of Nursing. Jamie Crandell, PhD, is Research Assistant Professor, University of North Carolina at Chapel Hill School of Nursing and Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina. Keely A. Muscatell, PhD, is Assistant Professor, Department of Psychology and Neuroscience, College of Arts and Sciences, University of North Carolina at Chapel Hill, with a dual appointment at the Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina. Hudson P. Santos, Jr., PhD, RN, is Assistant Professor; Ruth A. Anderson, PhD, RN, FAAN, is the Kenan Distinguished Professor and Associate Dean for Research; and Linda S. Beeber, PhD, PMHCNS-BC, FAAN, is Professor and Assistant Dean, PhD Division and PhD Program, University of North Carolina at Chapel Hill School of Nursing
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Zhu Y, Cohen SM, Rosenzweig MQ, Bender CM. Symptom Map of Endocrine Therapy for Breast Cancer: A Scoping Review. Cancer Nurs 2020; 42:E19-E30. [PMID: 30138143 PMCID: PMC6935534 DOI: 10.1097/ncc.0000000000000632] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Multiple symptoms associated with endocrine therapy have a detrimental impact on medication adherence and quality of life. OBJECTIVE The purpose of this scoping review is to map the symptoms during endocrine therapy for breast cancer to provide implications for current practice and suggestions for future research. METHODS The PubMed, CINAHL, and China Science Periodical Databases were searched to identify related studies published in English and Chinese languages. References of included articles were reviewed for additional eligible studies. Of the 2551 articles identified, 57 articles met inclusion criteria and were included in this scoping review. RESULTS Evidence for the 16 most studied symptoms and 15 most prevalent symptoms were synthesized. Five key symptoms associated with endocrine therapy were identified, including joint/muscle pain, hot flashes, low sexual interest/desire, joint/muscle stiffness, and fatigue/lack of energy. Rarely studied but highly prevalent symptoms and other gaps in the symptom science during endocrine therapy for breast cancer were identified. CONCLUSION Nurses caring for women receiving endocrine therapy for breast cancer should assess the 5 key symptoms identified. There remain substantial gaps in the science related to the symptom experience during endocrine therapy for breast cancer. Future studies should focus on the domains of symptom intensity and distress, specific understudied symptoms, symptom clusters, and development of symptom assessment instruments specific to symptoms associated with endocrine therapy. IMPLICATIONS FOR PRACTICE This scoping review identified 5 well-studied and highly prevalent symptoms that should be assessed in women with breast cancer receiving endocrine therapy.
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Affiliation(s)
- Yehui Zhu
- Author Affiliations: School of Nursing, University of Pittsburgh, Pennsylvania
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