Fatigue-related symptom clusters and functional status of older adults in hospice.
Fatigue-related symptom clusters and functional status of older adults in hospice.
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临终关怀老年人的疲劳相关症状群和功能状态。
DOI：
10.1017/s1478951522000207
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发表时间：
2023
影响因子：
2.2
通讯作者：
Wang,HsiaoLan
中科院分区：
文献类型：
--
作者：
Abduljawad,SuzanF;Beckstead,JasonW;Dobbs,Debra;Visovsky,Constance;Rodriguez,CarmenS;McMillan,SusanC;Wang,HsiaoLan
背景疲劳常与其他症状共存，在癌症患者和老年人群中非常普遍。在临终关怀中，缺乏对老年癌症患者疲劳集群的关注。目的探讨老年安宁疗护病人的疲劳相关症状群，并探讨疲劳相关症状群在控制抑郁的同时，对功能状态的预测程度。方法采用横断面研究方法，选取519名完成纪念症状评估量表、流行病学研究中心抑郁量表、波士顿简易量表和姑息治疗绩效量表的老年癌症安宁疗护病人为研究对象。从一项多中心症状试验中提取数据，采用探索性因素分析和层次多元回归分析进行二次分析。结果519例晚期癌症患者（78±7年）在家庭保健服务下接受临终关怀的数据显示，39%的参与者出现疲劳相关症状群（缺乏能量、感觉昏昏欲睡和食欲不振）。疲劳簇与抑郁呈显著正相关（r = 0.253, p < 0.01），与功能状态呈显著负相关（r = - 0.117, p < 0.01），是低功能状态的有力预测因子。此外，抑郁症对这种预测关系也有重要贡献。结论老年成人癌症安宁疗护患者有多种并发症状。疲劳特异性症状群与抑郁和预测功能状态显著相关。老年人，特别是临终关怀癌症患者，应定期监测疲劳，以帮助减少心理困扰和防止功能衰退。
Background Fatigue is frequently co-existing with other symptoms and is highly prevalent among patients with cancer and geriatric population. There was a lack of knowledge that focus on fatigue clusters in older adults with cancer in hospice care. Objectives To identify fatigue-related symptom clusters in older adult hospice patients and discover to what extent fatigue-related symptom clusters predict functional status while controlling for depression. Method This was a cross-sectional study in a sample of 519 older adult hospice patients with cancer, who completed the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression, Boston Short Form Scale, and the Palliative Performance Scale. Data from a multi-center symptom trial were extracted for this secondary analysis using exploratory factor analysis and hierarchical multiple regression analysis. Results Data from 519 patients (78 ± 7 years) with terminal cancer who received hospice care under home healthcare services revealed that 39% of the participants experienced fatigue-related symptom clusters (lack of energy, feeling drowsy, and lack of appetite). The fatigue cluster was significantly associated positively with depression (r = 0.253, p < 0.01), and negatively with functional status (r = −0.117, p < 0.01) and was a strong predictor of participants’ low functional status. Furthermore, depression made a significant contribution to this predictive relationship. Conclusion Older adult hospice patients with cancer experienced various concurrent symptoms. The fatigue-specific symptom cluster was identified significantly associated with depression and predicted functional status. Fatigue should be routinely monitored in older adults, especially among hospice cancer patients, to help reduce psychological distress and prevent functional decline.