Symptom Trajectories in Posttreatment Cancer Survivors
Symptom Trajectories in Posttreatment Cancer Survivors
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DOI：
10.1097/ncc.0b013e3181f04ae9
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发表时间：
2011-01-01
期刊：
影响因子：
2.6
通讯作者：
Miaskowski, Christine
中科院分区：
文献类型：
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作者：
Brant, Jeannine M.;Beck, Susan;Miaskowski, Christine
背景资料：癌症治疗后的癌症存活率是不确定的，因为与疾病或其治疗相关的身体和心理后遗症可能持续存在。然而，人们对治疗后的症状知之甚少。目的：本研究的目的是（1）检查化疗后（CTX后）癌症幸存者的症状轨迹和（2）确定人口统计学特征是否预测症状轨迹。研究方法：100例最近完成CTX治疗肺癌、结直肠癌或淋巴瘤的患者在门诊护理访视前在电子患者护理监测系统上对症状进行评级。进行潜伏生长曲线分析，以检查初始CTX后16个月的疼痛、疲劳、睡眠障碍、痛苦和抑郁的轨迹。结果：CTX治疗后首次随访时出现症状（P <0.0001），并持续16个月以上。抑郁轨迹是由性别预测的：男性表现出凸曲线生长轨迹，而女性表现出凹轨迹（P <0.05）。年龄越小，抑郁程度越高（P <0.05）。结论：心理和身体症状持续超过16个月的时间后，CTX的整个样本。应对的性别差异可以部分解释抑郁症不同的发展轨迹，但需要进一步的研究。年轻的患者在治疗后阶段可能更容易感到痛苦。对实践的影响：癌症幸存者的治疗后监测计划应包括对心理和身体症状的全面评估。某些患者的症状可能持续存在，应根据症状报告量身定制支持性干预措施。
Background: Cancer survivorship following cancer treatment is uncertain as physical and psychological sequelae related to the disease or its treatment may persist. However, little is known about the experience of symptoms after treatment. Objectives: The purposes of this study were to (1) examine postchemotherapy (post-CTX) symptom trajectories in cancer survivors and (2) determine whether demographic characteristics predicted symptom trajectories. Methods: One hundred patients who recently completed CTX for lung cancer, colorectal cancer, or lymphoma rated symptoms on an electronic patient care monitor system prior to ambulatory care visits. Latent growth curve analyses were conducted to examine the trajectories of pain, fatigue, sleep disturbance, distress, and depression for 16 months after initial CTX. Results: Symptoms were present at the first follow-up visit following CTX (P < .0001) and persisted over 16 months. The depression trajectory was predicted by sex: males showed a convex curvilinear growth trajectory, whereas females showed a concave trajectory (P < .05). Higher distress was predicted by younger age (P < .05). Conclusions: Psychological and physical symptoms persisted over the 16-month period following CTX for the entire sample. Sex differences in coping could partially explain the different trajectories of growth for depression, but further studies are warranted. Younger patients may be more vulnerable for distress during this posttreatment phase. Implications for Practice: The posttreatment surveillance plan for cancer survivors should include a comprehensive assessment of psychological and physical symptoms. Persistence of symptoms can be expected in some patients, and supportive interventions should be tailored according to symptom reports.