Symptom Cluster Patterns During the First Year After Diagnosis with Cancer
Symptom Cluster Patterns During the First Year After Diagnosis with Cancer
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DOI：
10.1016/j.jpainsymman.2009.09.012
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发表时间：
2010-05-01
影响因子：
4.7
通讯作者：
Kearney, Nora
中科院分区：
文献类型：
--
作者：
Molassiotis, Alex;Wengstrom, Yvonne;Kearney, Nora
上下文关于肿瘤学中症状簇的研究是一个新兴的研究领域。然而，关于症状群的概念仍然存在混淆，并且在研究中几乎没有一致性。本研究的目的是探讨集群的症状随着时间的推移在一个大的异质性组的癌症患者，从而有助于在这个研究领域的概念和方法的辩论。采用纵向设计，使用记忆症状评估量表在诊断后第一年内的四个时间点评估癌症患者的症状。这项研究招募了来自英国5个国家的143名患者。癌症中心，并提供了504个症状评估在治疗开始时和3，6，和12个月后。在首次评估时确定了6个症状群，这些症状群在各评估点保持不变，但略有变化。这些包括胃肠道、手/脚、身体形象、呼吸、营养和情绪症状群。随着时间的推移，集群的行为突出了症状集群评估的复杂性和症状之间的动态关系。出现一组症状的患者的频率、严重程度和症状带来的痛苦显著高于总体样本（高达75%），这表明对COPD患者的症状评估低估了患者亚组的症状负担。我们建议注意症状集群，是稳定的，随着时间的推移，包括核心或定义症状的集群内，我们进一步讨论的有用性和适用性的概念和方法的标准，在这项研究中用于未来的症状集群研究。J Pain Symptom Manage 2010;39：847-858. (C)2010年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. Research about clusters of symptoms in oncology is an emerging field of study. However, there is still conceptual confusion about clusters of symptoms and little agreement across studies.Objectives. The aim of the present study was to explore clusters of symptoms over time in a large heterogeneous group of patients with cancer and thereby contribute to the conceptual and methodological debate in this research area.Methods. A longitudinal design was used to assess symptoms in cancer patients over four time points during the first year after diagnosis using the Memorial Symptom Assessment Scale. The study recruited 143 patients from five U.K. cancer centers and provided 504 symptom assessments at the beginning of treatment and 3, 6, and 12 months later.Results. Six symptom clusters were identified at the first assessment, which were maintained across the assessment points with slight variations. These included gastrointestinal, hand/foot, body image, respiratory, nutritional, and emotional symptom clusters. The behavior of the clusters over time highlighted the complexities of symptom cluster assessment and the dynamic relationships between symptoms. Frequency, severity, and distress from symptoms were significantly higher (up to 75% higher) in patients who experienced a cluster of symptoms than in the overall sample, suggesting that symptom assessments in unselected patients underestimate the symptom burden in subgroups of patients.Conclusion. We propose attention to symptom clusters that are stable across time and include core or defining symptoms within the cluster, and we further discuss the usefulness and applicability of conceptual and methodological criteria used in this study for future symptom cluster research. J Pain Symptom Manage 2010;39:847-858. (C) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.