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Sun Q, Duan YL, Li CY, Xie JF, Cheng AS. The effectiveness of live music intervention on psychological distress among adolescent and young adult patients undergoing hematopoietic stem cell transplantation. J Psychosoc Oncol 2024:1-17. [PMID: 38972065 DOI: 10.1080/07347332.2024.2373232] [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: 07/09/2024]
Abstract
OBJECTIVE To explore the effects of live music to decrease psychological distress in adolescent and young adult (AYA) patients undergoing hematopoietic stem cell transplantation (HSCT). METHOD A quasi-experimental study was conducted. Sixty patients undergoing HSCT were divided into two groups, receiving either 4 week of live music (n = 31) or standard care (n = 29). Psychological distress, anxiety, the severity of symptom clusters and symptom interference were measured. RESULTS When compared with the immediately and 1 month after intervention, patients in LM intervention group had significantly lower psychological distress and anxiety level than wait-list group. AYA undergoing HSCT reported significantly milder general symptom cluster and neurological symptom cluster at T3 than at baseline. CONCLUSIONS Live music intervention showed a positive effect on relieving psychological distress and anxiety in AYA patients undergoing HSCT. However, further researches are warranted to explore the effects of live music intervention on symptom cluster.
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Affiliation(s)
- Qian Sun
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ying-Long Duan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Cheng-Yuan Li
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jian-Fei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Andy Sk Cheng
- Department of Re-habilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Luo Y, Luo J, Su Q, Yang Z, Miao J, Zhang L. Exploring Central and Bridge Symptoms in Patients with Lung Cancer: A Network Analysis. Semin Oncol Nurs 2024; 40:151651. [PMID: 38704342 DOI: 10.1016/j.soncn.2024.151651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES This study aimed to identify symptom clusters in lung cancer patients undergoing chemotherapy and the central and bridge symptoms within each symptom cluster. METHODS In this cross-sectional study, 1,255 patients with lung cancer were recruited through convenience sampling at Nanfang Hospital. Patient symptom burden was assessed using the M.D. Anderson Symptom Inventory (MDASI) and the Lung Cancer module of the MDASI (MDASI-LC). Symptom clusters were identified using the Walktrap algorithm, and central and bridge symptoms in the symptom clusters were identified by network analysis. RESULTS The patients included 818 (65.18%) males and 437 (34.82%) females with a mean age of 56.56 ± 11.78 years. Four symptom clusters were identified: fatigue, gastrointestinal, psychoneurological and respiratory. Their central symptoms were fatigue, vomiting, distress and hemoptysis, respectively, and their bridge symptoms were pain, vomiting, dry mouth and shortness of breath. CONCLUSIONS Lung cancer symptoms show certain strong correlations with each other, resulting in symptom clusters. Central symptoms may influence other symptoms within a symptom cluster, and bridge symptoms might impact the density of the symptom network. This study identified central and bridge symptoms in lung cancer patients undergoing chemotherapy. Targeting these symptoms with interventions for symptom clusters could make symptom management more precise and effective. IMPLICATIONS FOR NURSING PRACTICE In clinical settings, the burden of symptom clusters may be reduced by intervening against the central symptoms of these symptom clusters. Alternatively, if the objective is to diminish the connections between different symptom clusters and holistically alleviate the overall burden, interventions focused on bridge symptoms may be employed.
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Affiliation(s)
- Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiahui Luo
- Nursing Department of Taikang Tongji (Wuhan) Hospital, Wuhan, Hubei, China
| | - Qing Su
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
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Li Y, Wang Q, Liu C, Hu X. Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102465. [PMID: 37956567 DOI: 10.1016/j.ejon.2023.102465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning. METHOD A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis. RESULTS Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (β = -0.60, P = 0.02) and fatigue-related symptom cluster (β = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (β = -1.68, P < 0.01), role (β = -1.63, P < 0.01) and cognitive functioning (β = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (β = -1.26, P < 0.01); and the psychoneurological (β = -0.81, P < 0.01) and gastrointestinal symptom cluster (β = -0.60, P = 0.05) predicted social functioning. CONCLUSIONS Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.
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Affiliation(s)
- Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Qi Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Chunhua Liu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Chengdu, Sichuan, PR China.
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Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15030591. [PMID: 36765547 PMCID: PMC9913127 DOI: 10.3390/cancers15030591] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014-2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.
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An Investigation of Symptom Clusters and Sentinel Symptoms During the First 2 Cycles of Postoperative Chemotherapy in Patients With Lung Cancer. Cancer Nurs 2022; 45:488-496. [PMID: 35089876 DOI: 10.1097/ncc.0000000000001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lung cancer has the highest incidence and mortality of all cancers in China. Patients after a lobectomy experience serious physical and psychological symptoms during chemotherapy. Studies are lacking about symptom clusters (SCs) and sentinel symptoms during the postoperative chemotherapy period in lung cancer patients. OBJECTIVE The aim of this study was to explore SCs and sentinel symptoms during cycles 1 and 2 of postoperative chemotherapy in patients with lung cancer. METHODS Using a longitudinal study design, patients in treatment for lung cancer were measured at 2 separate points following a lobectomy: chemotherapy cycle 1 and chemotherapy cycle 2. The MD Anderson Symptom Inventory lung cancer-specific module and First Appearance of Symptoms Time Sheet were completed. RESULTS A total of 180 postoperative patients with lung cancer participated in the study. Four SCs were identified at chemotherapy cycle 1: gastrointestinal SC, respiratory tract SC, psychological SC, and somatic SC. The sentinel symptoms were nausea, cough, sadness, and fatigue. At chemotherapy cycle 2, similar SCs were identified, with the exception of merging the psychological SC and somatic SC, resulting in 3 clusters: gastrointestinal SC, respiratory tract SC, and psychological-somatic SC. The sentinel symptoms were nausea, cough, and fatigue. CONCLUSIONS Symptom clusters and sentinel symptoms were stable during the first 2 cycles of postoperative chemotherapy in patients with lung cancer. IMPLICATIONS FOR PRACTICE The understanding of SCs and sentinel symptoms could be beneficial to assess and manage both in postoperative patients with lung cancer during chemotherapy. Nurses should pay close attention to sentinel symptoms and develop effective interventions.
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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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Liao J, Wang Y, Dai W, Wei X, Yu H, Yang P, Xie T, Li Q, Liu X, Shi Q. Profiling symptom burden and its influencing factors at discharge for patients undergoing lung cancer surgery: a cross-sectional analysis. J Cardiothorac Surg 2022; 17:229. [PMID: 36057613 PMCID: PMC9441056 DOI: 10.1186/s13019-022-01974-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Following lung cancer surgery, patients often experience severe symptoms which are not properly assessed at discharge. The aim of this study was to identify the clinical presentation at discharge and the influencing factors of postoperative symptoms in patients who have undergone lung cancer surgery. Methods This cross-sectional study analysed data from patients who participated in a prospective cohort study that enrolled patients who underwent lung cancer surgery at six tertiary hospitals in the People’s Republic of China, from November 2017 to January 2020. Patient symptoms at discharge were measured using the MD Anderson Symptom Inventory Lung Cancer module. The five core symptoms were defined according to ratings of moderate to severe symptoms (≥ 4 on a 0–10 scale). A multivariate linear regression model was used to identify the influencing factors of each symptom at discharge. Results Among the 366 participants, 51.9% were male and the mean (SD) age was 55.81 (10.43) years. At discharge, the core symptoms were cough (36.4%), pain (28.2%), disturbed sleep (26.3%), shortness of breath (25.8%), and fatigue (24.3%), and more than half of the participants (54.6%) had one to five of the core symptoms, with moderate to severe severity. A low annual income and the use of two chest tubes were significantly associated (P = 0.030 and 0.014, respectively) with higher mean scores of the core symptoms. Conclusion Though clinically eligible for discharge, more than half of the participants had severe symptoms at discharge after lung cancer surgery. Special attention should be given to patients who have two chest tubes after surgery and those who have a low annual income.
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Affiliation(s)
- Jia Liao
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
| | - Yaqin Wang
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
| | - Xing Wei
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
| | - Hongfan Yu
- State Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People's Republic of China
| | - Pu Yang
- School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Tianpeng Xie
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
| | - Xiaoqin Liu
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China.
| | - Qiuling Shi
- Center for Cancer Prevention Research, Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Chengdu, 610041, Sichuan, People's Republic of China. .,School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.
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Lee HJ, Park SK. Factors Related to the Caregiving Burden on Families of Korean Patients With Lung Cancer. Clin Nurs Res 2022; 31:1124-1135. [PMID: 35575283 DOI: 10.1177/10547738221098150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purposes of this study were to describe caregiver burden on families of patients with lung cancer and to examine its associated factors, including patient symptoms and symptom clusters. In this cross-sectional study, 120 patient-caregiver dyads were recruited from an outpatient clinic in a tertiary care hospital. Patient symptoms and caregiver burden were measured with structured questionnaire. Descriptive and inferential statistics were used to analyze data. Three patient symptom clusters were identified. Hierarchical regression showed that a patient's smoking history; caregiver age, education, health status, depression, social support, monthly family income, relationship with patient, and time spent on nursing each day; and presence of another caregiver explained 41.4% of the total variance in caregiver burden. When patient symptom clusters were added to regression model, change in total variance in caregiver burden was significant. To reduce their burden, caregivers should be taught how cancer progresses and its major symptoms after chemotherapy.
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Li JJ, Li JR, Wu JM, Song YX, Hu SH, Hong JF, Wang W. Change in symptom clusters perioperatively in patients with lung cancer. Eur J Oncol Nurs 2021; 55:102046. [PMID: 34710809 DOI: 10.1016/j.ejon.2021.102046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the trajectory, number, and types of symptom clusters at three time points (i.e., day of admission [T1], 2-4 days postoperatively [T2], and 1 month postoperatively [T3]) using ratings of symptom occurrence and severity and to identify the changes in these symptom clusters over time in patients with lung cancer. METHODS We analysed the data of 217 lung cancer patients who received surgical treatment at a tertiary hospital affiliated to Anhui Medical University, in Hefei City, China. The occurrence and severity of 19 symptoms at all points of measurement were measured using the general and lung cancer modules of the M.D. Anderson Symptom Inventory. Exploratory factor analysis was performed to extract the symptom clusters. RESULTS Seven symptom clusters were identified across symptom dimensions. However, only three of them (i.e., lung cancer specific, sleep disturbance, and nervous system) were relatively stable across dimensions and time. Two symptom clusters varied over time but not with dimensions (nutritional and gastrointestinal). The other two symptom clusters (psychological and respiratory) differed in terms of time and dimensions. CONCLUSIONS Findings may provide insights into the seven identified clusters and overall stability of three symptom clusters in lung cancer patients perioperatively.
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Affiliation(s)
- Jing-Jing Li
- School of Nursing, Anhui Medical University, Hefei, China; Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Jing-Ru Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jing-Mei Wu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yong-Xia Song
- School of Nursing, Anhui Medical University, Hefei, China
| | - Shao-Hua Hu
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing-Fang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Abstract
BACKGROUND Lung cancer has become the leading cause of cancer-related deaths in China, and patients often experience multiple symptoms and substantial discomfort. Understanding and managing concurrent symptoms of patients with lung cancer are crucial during perichemotherapy. OBJECTIVE To determine the types and components of symptom clusters according to the severity dimension and to understand how they change over time during perichemotherapy in a homogeneous population of patients with lung cancer. METHODS Patients were recruited using convenience sampling. The Chinese version of the MD Anderson Symptom Inventory and the revised lung cancer module were used to measure multiple symptoms at the following 3 separate points: 2 weeks before chemotherapy (T1), chemotherapy cycle 1 (T2), and chemotherapy cycle 4 (T3). Symptom clusters were identified by exploratory factor analysis. RESULTS A total of 144 patients with non-small cell lung cancer participated in the study. Six symptom clusters were identified at the 3 time points. Among the 6 symptom clusters, 3 symptom clusters remained stable at all time points, and differences were found in symptom clusters before and after chemotherapy. CONCLUSIONS Symptom clusters can change during perichemotherapy, showing some stability and differences over time. IMPLICATIONS FOR PRACTICE An improved understanding of symptom cluster trajectories in patients with lung cancer may facilitate effective assessment, prevention, and management of multiple concurrent symptoms. These findings will help clinicians to develop predictive interventions and reduce the symptom burden of patients undergoing chemotherapy.
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Tang H, Chen L, Wang Y, Zhang Y, Yang N, Yang N. The efficacy of music therapy to relieve pain, anxiety, and promote sleep quality, in patients with small cell lung cancer receiving platinum-based chemotherapy. Support Care Cancer 2021; 29:7299-7306. [PMID: 34041615 DOI: 10.1007/s00520-021-06152-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Chemotherapy induces a range of physical and psychological symptoms, including pain, sleep disorders, fatigue, and anxiety. We aimed to assess the efficacy of six-step music therapy in relieving pain and anxiety and improving sleep quality in lung cancer patients receiving platinum-based chemotherapy. METHODS Between March 2013 and October 2015, we enrolled a total of 100 patients who were diagnosed with small cell lung cancer and scheduled for platinum-based chemotherapy. Patients were randomly assigned to two groups: the music therapy group (received six-step music therapy, n=50) and the control group (not received six-step music therapy, n=50). The anxiety, pain, and sleep quality of all patients were assessed using the self-rating anxiety scale (SAS), the visual analogue scale (VAS), and the Pittsburgh Sleep Quality Index (PSQI), respectively. RESULTS There were no significant differences in the demographic characteristics and music background between the two groups. The SAS and VAS scores in the two groups were not statistically different before chemotherapy. However, patients in the music therapy group showed significantly lower SAS and VAS scores compared with the control group at both 1 day and 5 days after chemotherapy. (SAS score at 1-day post-therapy, 49.48±2.14 vs 61.46±8.8, P=0.011; SAS score at 5-day post-therapy, 39.73±1.79 vs 62.02±8.83, P=0.005; VAS score at 1-day post-therapy, 2.14±0.78 vs 4.74±1.01, P=0.005; VAS score at 5-day post-therapy, 2.06±0.79 vs 4.74±1.08, P=0.004). In addition, the total PSQI score of patients who received music therapy was also significantly higher than that of the control group after therapy (total PSQI score at 1-day post-therapy, 8.50±1.69 vs 17.81±3.01, P=0.006; total PSQI score at 5-day post-chemotherapy, 9.84±3.02 vs 18.66±2.91, P=0.012). CONCLUSION The music therapy was an effective approach in alleviating pain and anxiety and promoting sleep quality in lung cancer patients receiving platinum-based chemotherapy. TRIAL REGISTRATION Chinese Clinical Trial Registry (registration number: ChiCTR-TRC-13003993).
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Affiliation(s)
- Haoke Tang
- Music Therapist of Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China
| | - Liping Chen
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China
| | - Yichun Wang
- Department of Critical Care Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China
| | - Yongchang Zhang
- Department of Lung Cancer and Gastroenterology, Hunan Cancer Hospital, Changsha, 410013, Hunan Province, People's Republic of China
| | - Nong Yang
- Department of Lung Cancer and Gastroenterology, Hunan Cancer Hospital, Changsha, 410013, Hunan Province, People's Republic of China
| | - Ning Yang
- Department of Neurology, The Third Affiliated Hospital of Guangzhou Medical University, No.63, Duobao Road, Liwan District, Guangzhou, 510150, Guangdong Province, People's Republic of China.
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Silva ACAE, Santos IC, Carmo CND, Mattos IE. Symptoms and factors associated with symptom clusters among older adults with oral and oropharyngeal cancers at diagnosis. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: Describe differences in pretreatment symptoms and the composition of symptom clusters in older patients with oral and oropharyngeal cancer.
METHODS: In this cross-sectional study, quality of life (QoL) assessments for cancer patients (EORCT QLQ-C30 and QLQ-H & N35) were applied to 161 cases of oral and oropharyngeal cancer at the time of enrollment in an outpatient clinic. They were used to evaluate QoL-related symptoms reported by patients, according to their occurrence. To identify symptom clusters, an exploratory factor analysis (EFA) was performed, and the relationships between these clusters and independent variables were assessed with linear regression models. RESULTS: The most prevalent symptoms were pain (52%), worry (48%), and weight loss (44%). Five factors were extracted from the EFA, of which 3 were noteworthy. The dysphagia cluster was common to both cancer sites, although more frequent in oropharyngeal cancer patients, and included symptoms such as difficulty swallowing, pain, and weight loss. The psychological cluster included symptoms related to feeling worried, nervous, and depressed. The asthenia cluster, in addition to being age-related, may represent the advanced stage or progression of the disease. CONCLUSION: The dysphagia cluster loaded the most symptoms and was common to both cancers. In addition to pain (one of the main symptoms of the dysphagia cluster), psychological symptoms were also important in both groups of patients. Adequate and early control of these symptom clusters at diagnosis could favor better management of symptoms during treatment.
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Lin Y, Docherty SL, Porter LS, Bailey DE. Symptom experience and self-management for multiple co-occurring symptoms in patients with gastric cancer: A qualitative study. Eur J Oncol Nurs 2020; 49:101860. [DOI: 10.1016/j.ejon.2020.101860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/17/2020] [Accepted: 10/16/2020] [Indexed: 12/23/2022]
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Li Y, Ling L, Zhanyu P. Effect of Wellness Education on Quality of Life of Patients With Non-Small Cell Lung Cancer Treated With First-Line Icotinib and on Their Family Caregivers. Integr Cancer Ther 2019; 18:1534735419842373. [PMID: 31043093 PMCID: PMC6498762 DOI: 10.1177/1534735419842373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective: To examine the effects of a wellness-education intervention on quality of life (QOL) of patients with NSCLC treated with icotinib and on their caregivers. Methods: This feasibility study was a prospective pilot randomized controlled trial to evaluate a wellness-education intervention in NSCLC patients and caregivers undergoing icotinib treatment. The participants in the wellness-education group were provided with well-being information over 8 weeks. The Family Environment Scale (FES), Functional Assessment of Cancer Therapy–Lung (FACT-L), Caregiver QOL Index–Cancer Scale (CQOLC), and Hospital Anxiety and Depression Scale (HADS) were measured at baseline prior to randomization and after 8 weeks. Patients completed the FACT-L and HADS, caregivers completed the CQOLC and FES. Results: 67 patients/caregivers in the wellness-education group and 71 in the control group could be analyzed. Feasibility targets were the following: (1) >70% study enrollment of eligible patients; (2) >90% of participants completing this study; (3) <10% missing data. Wellness-education group had better change scores at 8 weeks for the emotional well-being subscale of FACT-L (12.8 vs 15.6, P = .014), anxiety subscale of HADS (6.1 vs 6.7, P = .030), adaptation (66.0 vs 54.7, P = .037) and financial subscales of CQOLC (70.8 vs 69.8, P = .044), and the cohesion (7.3 ± 1.8 vs 5.7 ± 1.7, P= .021) and conflict (3.4 ± 1.9 vs 4.5 ± 1.7, P = .031) subscales of the FES. Conclusion: Wellness-education in patients/caregivers with NSCLC treated with icotinib are feasible and could improve patients’ QOL and their relationship with caregivers.
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Affiliation(s)
- Yanwei Li
- 1 Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Li Ling
- 1 Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Pan Zhanyu
- 1 Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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15
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Han CJ, Reding K, Cooper BA, Paul SM, Conley YP, Hammer M, Kober KM, Levine JD, Miaskowski C. Stability of Symptom Clusters in Patients With Gastrointestinal Cancers Receiving Chemotherapy. J Pain Symptom Manage 2019; 58:989-1001.e10. [PMID: 31404646 PMCID: PMC6878189 DOI: 10.1016/j.jpainsymman.2019.07.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Limited evidence suggests that patients with gastrointestinal (GI) cancers receiving chemotherapy (CTX) experience an average of 13 co-occurring symptoms. An alternative to counting symptoms is to evaluate for symptom clusters. OBJECTIVES In a sample of patients with GI cancers receiving CTX (n = 399), we evaluated the occurrence, severity, and distress of 38 symptoms in the week before patients' second or third cycle of CTX (Time 1 [T1]), approximately one week after CTX (Time 2 [T2]), and approximately two weeks after CTX (Time 3 [T3]); evaluated for differences in the number and types of symptom clusters at each of these three assessments using ratings of occurrence, severity, and distress; and evaluated for changes in symptom clusters over time. METHODS Modified version of the Memorial Symptom Assessment Scale collected data on 38 common symptoms. Exploratory factor analyses were used to create the symptom clusters. RESULTS Five distinct symptom clusters were identified across the three symptom dimensions and the three assessments (i.e., psychological, CTX-related, weight change, GI, and epithelial). Psychological, CTX-related, and weight change clusters were relatively stable across all three symptom dimensions and time. Across all three symptom dimensions, GI cluster was identified only at T1 and epithelial cluster was identified at T2 and T3. CONCLUSION The number and types of symptom clusters appear to be relatively stable over time and across the symptom dimensions. Ongoing assessment and management of these clusters is warranted across the entire course of CTX. The underlying mechanism for these clusters warrants investigation.
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Affiliation(s)
- Claire J Han
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Kerryn Reding
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Medical Center, New York, New York, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
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Guo M, Wang C, Yin X, Nie L, Wang G. Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery. J Clin Nurs 2019; 28:3441-3450. [PMID: 31162849 DOI: 10.1111/jocn.14935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 04/29/2019] [Accepted: 05/26/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Min Guo
- School of Nursing Shandong University Jinan China
| | - Cui Wang
- School of Nursing Shandong University Jinan China
| | - Xiumin Yin
- School of Nursing Shandong University Jinan China
| | - Liting Nie
- School of Nursing Shandong University Jinan China
| | - Gongchao Wang
- School of Nursing Shandong University Jinan China
- Shandong Provincial Hospital Affiliated to Shandong University Jinan China
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17
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Symptom Clusters and Influencing Factors in Children With Acute Leukemia During Chemotherapy. Cancer Nurs 2019; 43:411-418. [DOI: 10.1097/ncc.0000000000000716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Russell J, Wong ML, Mackin L, Paul SM, Cooper BA, Hammer M, Conley YP, Wright F, Levine JD, Miaskowski C. Stability of Symptom Clusters in Patients With Lung Cancer Receiving Chemotherapy. J Pain Symptom Manage 2019; 57:909-922. [PMID: 30768960 PMCID: PMC6486424 DOI: 10.1016/j.jpainsymman.2019.02.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/01/2019] [Accepted: 02/05/2019] [Indexed: 11/24/2022]
Abstract
CONTEXT Patients with lung cancer who undergo chemotherapy (CTX) experience multiple symptoms. Evaluation of how these symptoms cluster together and how these symptom clusters change over time are salient questions in symptom clusters research. OBJECTIVES The purposes of this analysis, in a sample of patients with lung cancer (n = 145) who were receiving CTX, were to 1) evaluate for differences in the number and types of symptom clusters at three time points (i.e., before their next cycle of CTX, the week after CTX, and two weeks after CTX) using ratings of symptom occurrence and severity and 2) evaluate for changes in these symptom clusters over time. METHODS At each assessment, a modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence and severity of 38 symptoms. Exploratory factor analyses were used to extract the symptom clusters. RESULTS Across the two symptom dimensions (i.e., occurrence and severity) and the three assessments, six distinct symptom clusters were identified; however, only three of these clusters (i.e., lung cancer specific, psychological, nutritional) were relatively stable across both dimensions and across time. Two additional clusters varied by time but not by symptom dimension (i.e., epithelial/gastrointestinal and epithelial). A sickness behavior cluster was identified at each assessment with the exception of the week before CTX using only the severity dimension. CONCLUSION Findings provide insights into the most common symptom clusters in patients with lung cancer undergoing CTX. Most common symptoms within each cluster appear to be relatively stable across the two dimensions, as well as across time.
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Affiliation(s)
- Jacquelyn Russell
- School of Nursing, University of California, San Francisco, California, USA
| | - Melisa L Wong
- School of Medicine, University of California, San Francisco, California, USA
| | - Lynda Mackin
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Medical Center, New York, New York, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
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19
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Blakeman JR. An integrative review of the theory of unpleasant symptoms. J Adv Nurs 2018; 75:946-961. [PMID: 30397941 DOI: 10.1111/jan.13906] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/07/2018] [Accepted: 10/08/2018] [Indexed: 01/04/2023]
Abstract
AIMS The aim of this study was to explore how the theory of unpleasant symptoms (TOUS) has been used in the methodological design and analysis of symptom research. DESIGN An integrative review, using Whittemore and Knafl's approach. DATA SOURCES Searches were conducted between 26 January-10 February 2018. Databases included CINAHL Complete, PubMed, Proquest Nursing and Allied Health Source, Health Source: Nursing/Academic Edition, Academic Search Complete and Google Scholar. REVIEW METHODS A systematic approach to searching, screening and analysing the literature was applied. The matrix method, content analysis, constant comparison, counting and clustering were used. RESULTS Sixty-four records were included. Most studies were quantitative, cross-sectional, instrument-based and conducted in the USA. Various symptoms and patient populations were represented and each of the TOUS concepts were explored. CONCLUSION Although the theory has a role to play in furthering symptom science, attention should be paid to the areas of the model and of symptom research that have received less attention. More complex statistical approaches and big data will help to illuminate symptom experiences. Additional focus on intervention studies and all symptom dimensions will help to advance symptom science research. IMPACT This review is the first to provide a comprehensive, systematic summary of the uses of the TOUS across the research literature to date. This theory is a diverse, holistic middle-range theory capable of being applied to multiple symptoms and populations. Researchers should consider using the theory as a conceptual framework for studies to advance symptom science and explore symptoms holistically.
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Affiliation(s)
- John R Blakeman
- Mennonite College of Nursing, Illinois State University, Normal, Illinois.,School of Nursing, Millikin University, Decatur, Illinois
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20
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Chabowski M, Jankowska-Polańska B, Lomper K, Janczak D. The effect of coping strategy on quality of life in patients with NSCLC. Cancer Manag Res 2018; 10:4085-4093. [PMID: 30323664 PMCID: PMC6173489 DOI: 10.2147/cmar.s175210] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background A cancer diagnosis is a source of emotional distress. The aim of the study was to evaluate coping strategies in patients with non-small-cell lung carcinoma and to assess how coping strategies along with other factors affect their quality of life. Patients and methods A total of 185 patients with non-small-cell lung carcinoma were enrolled in this observational, cross-sectional study. Demographic and clinical data were collected. Strategies for coping with cancer were assessed using a shortened version of the Mental Adjustment to Cancer (MiniMAC) scale. Health-related quality of life was assessed using the Short Form-8 Health Survey. Results Respondents (mean age: 62.84±9.6 years) most often emerged as using a fighting strategy, whereas a sense of helplessness was the strategy used least often. Overall, 65% of the respondents were revealed to have a medium level of constructive style of coping, whereas 62% had a medium level of destructive style. The coping style of nearly 50% of the respondents was predominantly constructive. Patients whose coping style was predominantly constructive had a significantly higher level of quality of life than patients whose coping style was predominantly destructive or whose results showed a balance between the two coping styles. Lung cancer patients had higher scores on the mental functioning scale (mental component summary = 50.20±39.26) than on the physical functioning scale (physical component summary = 40.07±28.58). Conclusion The majority of lung cancer patients use effective strategies for coping with the disease, which correlates with a better quality of life; a compromised quality of life is associated with a destructive coping style. Physicians should endeavor to promote positive, constructive, problem-oriented strategies of coping, especially in patients with a compromised quality of life, where the disease is advanced and when there are comorbidities.
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Affiliation(s)
- Mariusz Chabowski
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland, .,Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland,
| | - Beata Jankowska-Polańska
- Division of Nursing in Internal Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Lomper
- Division of Nursing in Internal Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Dariusz Janczak
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland, .,Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland,
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21
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Sullivan CW, Leutwyler H, Dunn LB, Cooper BA, Paul SM, Levine JD, Hammer M, Conley YP, Miaskowski CA. Stability of Symptom Clusters in Patients With Breast Cancer Receiving Chemotherapy. J Pain Symptom Manage 2018; 55:39-55. [PMID: 28838866 PMCID: PMC5734998 DOI: 10.1016/j.jpainsymman.2017.08.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 01/08/2023]
Abstract
CONTEXT Patients with breast cancer who undergo chemotherapy (CTX) experience between 10 and 32 concurrent symptoms. An evaluation of how these symptoms cluster together and how these symptom clusters change over time may provide insights into how to treat these multiple co-occurring symptoms. OBJECTIVES The purposes of this study were to determine the occurrence rates and severity ratings for 38 common symptoms, evaluate for differences in the number and types of symptom clusters, and evaluate for changes over time in these symptom clusters (i.e., before CTX, the week after CTX, and two weeks after CTX). METHODS At each of the assessments, a modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence and severity of the 38 symptoms. Exploratory factor analyses were used to extract the symptom clusters. RESULTS Although across the two symptom dimensions (i.e., occurrence and severity) and the three assessments, eight distinct symptom clusters were identified, only five were relatively stable across both dimensions and across time (i.e., psychological, hormonal, nutritional, gastrointestinal, and epithelial). Two of the additional clusters varied by time but not by symptom dimension (i.e., sickness behavior and weight change). The CTX neuropathy cluster was identified only at the assessment performed in the week after CTX. CONCLUSION These findings provide insights into the most common symptom clusters in patients undergoing CTX for breast cancer. In addition, the most common symptoms within each cluster appear to be relatively stable across the two dimensions, as well as across time.
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Affiliation(s)
- Carmen W Sullivan
- School of Nursing, University of California, San Francisco, California, USA
| | - Heather Leutwyler
- School of Nursing, University of California, San Francisco, California, USA
| | - Laura B Dunn
- School of Medicine, Stanford University, Palo Alto, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Medical Center, New York, New York, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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22
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Ward Sullivan C, Leutwyler H, Dunn LB, Miaskowski C. A review of the literature on symptom clusters in studies that included oncology patients receiving primary or adjuvant chemotherapy. J Clin Nurs 2017; 27:516-545. [PMID: 28859255 DOI: 10.1111/jocn.14057] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVES To summarise the current state of knowledge of symptom clusters research from studies that included, as part of their sample, patients who were receiving primary or adjuvant chemotherapy. BACKGROUND Since the concept of a symptom cluster was first introduced into the oncology literature in 2001, only four comprehensive reviews of symptom clusters research in oncology patients were identified that provide insights into this important concept in symptom management research. DESIGN A comprehensive review of the literature. METHODS A comprehensive literature search was conducted for the years 2000 to 2016. Only 19 studies met the inclusion criteria for this literature review. These studies were evaluated in terms of the symptom assessment instruments used; the statistical analysis methods used; the symptom dimension(s) used to create the symptom cluster(s); the number and types of symptom clusters identified; and whether the specific symptom clusters changed over time. RESULTS The number of symptom clusters identified ranged from one-seven. The majority of the studies used some type of factor analysis to create the symptom clusters. The most common symptom dimension used to create the clusters was symptom severity. A "gastrointestinal symptom cluster" was the most common symptom cluster identified. Across the eight longitudinal studies, for half of these studies the symptom clusters remained relatively stable over time. CONCLUSIONS Additional research is needed in oncology patients to address the assessment of symptom clusters, the specific nature of symptom clusters and whether symptom clusters change over time.
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23
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Miaskowski C, Conley YP, Mastick J, Paul SM, Cooper BA, Levine JD, Knisely M, Kober KM. Cytokine Gene Polymorphisms Associated With Symptom Clusters in Oncology Patients Undergoing Radiation Therapy. J Pain Symptom Manage 2017; 54:305-316.e3. [PMID: 28797847 PMCID: PMC5610097 DOI: 10.1016/j.jpainsymman.2017.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/07/2017] [Accepted: 05/09/2017] [Indexed: 01/08/2023]
Abstract
CONTEXT Most of the reviews on the biological basis for symptom clusters suggest that inflammatory processes are involved in the development and maintenance of the symptom clusters. However, no studies have evaluated for associations between genetic polymorphisms and common symptom clusters (e.g., mood disturbance, sickness behavior). OBJECTIVES Examine the associations between cytokine gene polymorphisms and the severity of three distinct symptom clusters (i.e., mood-cognitive, sickness-behavior, treatment-related) in a sample of patients with breast and prostate cancer (n = 157) at the completion of radiation therapy. METHODS Symptom severity was assessed using the Memorial Symptom Assessment Scale. Symptom clusters were created using exploratory factor analysis. The associations between cytokine gene polymorphisms and the symptom cluster severity scores were evaluated using regression analyses. RESULTS Polymorphisms in C-X-C motif chemokine ligand 8 (CXCL8), interleukin (IL13), and nuclear factor kappa beta 2 (NFKB2) were associated with severity scores for the mood-cognitive symptom cluster. In addition to interferon gamma (IFNG1), the same polymorphism in NFKB2 (i.e., rs1056890) that was associated with the mood-cognitive symptom cluster score was associated with the sickness-behavior symptom cluster. Polymorphisms in interleukin 1 receptor 1 (IL1R1), IL6, and NFKB1 were associated with severity factor scores for the treatment-related symptom cluster. CONCLUSION Our findings support the hypotheses that symptoms that cluster together have a common underlying mechanism and the most common symptom clusters in oncology patients are associated polymorphisms in genes involved in a variety of inflammatory processes.
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Affiliation(s)
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Mitchell Knisely
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
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24
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Wong ML, Cooper BA, Paul SM, Levine JD, Conley YP, Wright F, Hammer M, Miaskowski C. Differences in Symptom Clusters Identified Using Ratings of Symptom Occurrence vs. Severity in Lung Cancer Patients Receiving Chemotherapy. J Pain Symptom Manage 2017; 54:194-203. [PMID: 28533161 PMCID: PMC5557657 DOI: 10.1016/j.jpainsymman.2017.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/13/2017] [Accepted: 04/05/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT An important question in symptom clusters research is whether the number and types of symptom clusters vary based on the specific dimension of the symptom experience used to create the clusters. OBJECTIVES Given that lung cancer patients undergoing chemotherapy (CTX) report an average of 14 co-occurring symptoms and studies of symptom clusters in these patients are limited, the purpose of this study, in lung cancer patients undergoing CTX (n = 145), was to identify whether the number and types of symptom clusters differed based on whether symptom occurrence rates or symptom severity ratings were used to create the clusters. METHODS A modified version of the Memorial Symptom Assessment Scale was used to assess for the occurrence and severity of 38 symptoms, one week after the administration of CTX. Exploratory factor analysis was used to extract the symptom clusters. RESULTS Both the number and types of symptom clusters were relatively similar using symptom occurrence rates or symptom severity ratings. Five symptom clusters were identified using both symptom occurrence rates and severity ratings (i.e., sickness behavior, lung cancer specific, psychological, nutritional, and epithelial). Across these two dimensions, the specific symptoms within each of the symptom clusters were relatively similar. CONCLUSIONS Identification of symptom clusters in patients with lung cancer may assist with the development of more targeted symptom management interventions. Future studies are warranted to determine if symptom clusters change over a cycle of CTX in patients with lung cancer.
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Affiliation(s)
- Melisa L Wong
- School of Medicine, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fay Wright
- Yale School of Nursing, New Haven, Connecticut, USA
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Hospital, New York, New York, USA
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Xiao W, Chan CW, Fan Y, Leung DY, Xia W, He Y, Tang L. Symptom clusters in patients with nasopharyngeal carcinoma during radiotherapy. Eur J Oncol Nurs 2017; 28:7-13. [DOI: 10.1016/j.ejon.2017.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 12/16/2016] [Accepted: 02/20/2017] [Indexed: 12/23/2022]
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26
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Lee SE, Vincent C, Finnegan L. An Analysis and Evaluation of the Theory of Unpleasant Symptoms. ANS Adv Nurs Sci 2017; 40:E16-E39. [PMID: 27525959 DOI: 10.1097/ans.0000000000000141] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Theory of Unpleasant Symptoms was developed to enhance understanding of relationships among multiple symptoms and symptom experiences. Although the theory has been used to guide research, no formal critique of the theory has been published since 2000. This article comprehensively analyzes and evaluates the theory using Fawcett and DeSanto-Madeya's framework. Although its semantic clarity, semantic and structural consistency, and parsimony could be improved, the theory demonstrates good social and theoretical significance, testability, and empirical and pragmatic adequacy. Understanding multiple patient symptoms is essential, and the theory demonstrates that nurses should focus on multiple rather than individual symptoms.
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27
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The Effectiveness of Psychoeducational Intervention on Managing Symptom Clusters in Patients With Cancer. Cancer Nurs 2016; 39:279-91. [DOI: 10.1097/ncc.0000000000000313] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Tumwine JK. Non communicable diseases and infections refuse to go away despite current knowledge and scientific advances. Afr Health Sci 2014; 14:i-iv. [PMID: 26060491 DOI: 10.4314/ahs.v14i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- James K Tumwine
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda
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