Finnegan Lorna, Shaver Joan L, Zenk Shannon N, Wilkie Diana J, Ferrans Carol Estwing
College of Nursing, University of Illinois at Chicago, USA.
Oncol Nurs Forum. 2010 Nov;37(6):E377-86. doi: 10.1188/10.ONF.E377-E386.
PURPOSE/OBJECTIVES: To present the novel Symptom Cluster Experience Profile (SCEP) framework for guiding symptom research in adult survivors of childhood cancers and other subgroups at risk for high symptom burden.
Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers.
In a previous study, the authors generated a preliminary model to characterize subgroups of adult survivors of childhood cancers with high-risk symptom cluster profiles. The authors developed the SCEP framework, which depicts symptom cluster experiences as subgroup-specific profiles that are driven by multiple sets of risk and protective factors. The risk and protective factors may directly and indirectly contribute to or alleviate symptoms through their effects on systemic stress. Systemic stress instigates and sustains the symptom experience that, in turn, is expressed through negative diffusion into other components of quality of life, such as functional status, general health perceptions, and overall quality of life.
The SCEP framework is an initial approach to unbundle the complex heterogeneity that underlies the clustering of symptoms. By measuring a wide range of risk and protective factors in future studies of adult survivors of childhood cancers and other subgroups at risk for high symptom burden, further development and validation of the SCEP framework will occur.
The SCEP framework can be used to specify mechanisms underlying symptom cluster profiles and derive interventions targeted to high-risk symptom profiles. Findings from future studies can be translated to risk-based surveillance and symptom management clinical practice guidelines.
目的/目标：介绍新颖的症状群体验概况（SCEP）框架，以指导儿童癌症成年幸存者及其他有高症状负担风险的亚组中的症状研究。
基于实证得出的症状群体验概况模型、现有的理论框架以及关于儿童癌症成年幸存者症状与生活质量的基于数据的文献。
在之前的一项研究中，作者生成了一个初步模型，以刻画具有高风险症状群概况的儿童癌症成年幸存者亚组。作者开发了SCEP框架，该框架将症状群体验描述为由多组风险和保护因素驱动的亚组特异性概况。风险和保护因素可能通过对全身应激的影响直接或间接导致或减轻症状。全身应激引发并维持症状体验，而症状体验又通过负面扩散到生活质量的其他组成部分，如功能状态、总体健康认知和整体生活质量中得以体现。
SCEP框架是一种初步方法，用于剖析症状群背后复杂的异质性。通过在未来对儿童癌症成年幸存者及其他有高症状负担风险的亚组的研究中测量广泛的风险和保护因素，SCEP框架将得到进一步发展和验证。
SCEP框架可用于明确症状群概况背后的机制，并推导针对高风险症状概况的干预措施。未来研究的结果可转化为基于风险的监测和症状管理临床实践指南。
