Symptom Clusters in Cancer Patients Undergoing Treatment

描述（由申请人提供）：拟议试点研究的具体目的是：1)系统地检查癌症化疗期间通常经历的一组身体症状（疲劳、失眠、疼痛和恶心/呕吐）之间的关系，以确定它们是否形成一个或多个集群；并且，2)测试这些症状（和/或症状群）对心理和功能健康影响的替代模型。本研究的总体目标是为癌症治疗过程中症状群的特征和影响的未来研究提供假设。症状集群的指标包括两个或多个症状，它们具有共同的预测因子（或原因）、模式或对另一个症状的影响。纵向描述性设计将用于检查一个化疗周期内的症状和生活质量。将在三个数据点采取措施：1)化疗前周期第1天；2)周期第4天；3)周期的最后一天。在这些数据点实施措施将使我们能够跟踪从治疗前的基线到疲劳、失眠和延迟性恶心/呕吐的已知症状高点（第4天）到已知症状低点（最后一天）的症状模式。重复测量的使用将使我们能够检查症状模式以及时间模式，通过这些模式，症状可能随着时间的推移影响其他症状。这种设计还允许我们在每个数据点上检查症状与其他生活质量维度之间的关系以及随时间的变化。对于目标#1，将使用相关性，多元回归和/或重复测量ANOVA独立检查五个研究问题。每次分析的结果将提供一个症状集群存在或不存在的指示。指标的数量和所描述的关系的性质将用于决定所调查的症状是否形成群集。对于目标#2，将使用多元回归技术检查两个假设，以测试功能健康是否是个体症状（或症状群）和心理健康之间的中介。

DESCRIPTION (provided by applicant): The specific aims of the proposed pilot research are to: 1) systematically examine the relationships between and among a group of physical symptoms (fatigue, insomnia, pain, and nausea/vomiting) typically experienced during cancer chemotherapy to determine whether or not they form one or more clusters; and, 2) test alternative models of the impact of these symptoms (and/or symptom clusters) on psychological and functional well-being. The overall goal of this research is to generate hypotheses for future research about the characteristics and effects of symptom clusters during cancer treatment. Indicators of a symptom cluster include two or more symptoms with a common predictor (or cause), pattern, or effect on another symptom(s). A longitudinal descriptive design will be used to examine symptoms and quality of life during one cycle of chemotherapy. Measures will be taken at three data points: 1) day 1 of cycle prior to receiving chemotherapy; 2) day 4 of cycle; 3) last day of cycle. Administering measures at these data points will allow us to track the pattern of symptoms from baseline before treatment to a known symptom high point (day 4) for fatigue, insomnia, and delayed nausea/vomiting to a known symptom low point (last day). The use of repeated measures will enable us to examine symptom patterns as well as temporal patterns by which symptoms could influence other symptoms over time. This design also will allow us to examine relationships between symptoms and other quality of life dimensions at each data point as well as changes over time. For aim #1, five research questions will be examined independently using correlation, multiple regressions, and/or repeated measures ANOVA. The result of each analysis will provide one indication of the presence or absence of a symptom cluster. The number of indicators and the nature of the relationships described will be used to decide whether or not the symptoms under investigation form a cluster. For aim #2, two hypotheses will be examined using multiple regression techniques to test whether functional well-being is a mediator between individual symptoms (or symptom clusters) and psychological well-being.