Barsevick Andrea M, Whitmer Kyra, Nail Lillian M, Beck Susan L, Dudley William N
Fox Chase Cancer Center, 510 Township Line Road, Cheltenham, PA 19012, USA.
J Pain Symptom Manage. 2006 Jan;31(1):85-95. doi: 10.1016/j.jpainsymman.2005.05.015.
Cancer patients may experience multiple concurrent symptoms caused by the cancer, cancer treatment, or their combination. The complex relationships between and among symptoms, as well as the clinical antecedents and consequences, have not been well described. This paper examines the literature on cancer symptom clusters focusing on the conceptualization, design, measurement, and analytic issues. The investigation of symptom clustering is in an early stage of testing empirically whether the characteristics defined in the conceptual definition can be observed in cancer patients. Decisions related to study design include sample selection, the timing of symptom measures, and the characteristics of symptom interventions. For self-report symptom measures, decisions include symptom dimensions to evaluate, methods of scaling symptoms, and the time frame of responses. Analytic decisions may focus on the application of factor analysis, cluster analysis, and path models. Studying the complex symptoms of oncology patients will yield increased understanding of the patterns of association, interaction, and synergy of symptoms that produce specific clinical outcomes. It will also provide a scientific basis and new directions for clinical assessment and intervention.
癌症患者可能会经历由癌症、癌症治疗或两者共同导致的多种并发症状。症状之间以及症状与临床前因后果之间的复杂关系尚未得到充分描述。本文审视了关于癌症症状群的文献，重点关注其概念化、设计、测量和分析问题。症状群的研究正处于实证检验概念定义中所界定的特征是否能在癌症患者身上观察到的早期阶段。与研究设计相关的决策包括样本选择、症状测量的时间安排以及症状干预的特征。对于自我报告的症状测量，决策包括要评估的症状维度、症状的评分方法以及回答的时间范围。分析决策可能集中在因子分析、聚类分析和路径模型的应用上。研究肿瘤患者的复杂症状将增进对产生特定临床结果的症状关联、相互作用和协同模式的理解。这也将为临床评估和干预提供科学依据和新方向。
