School of Nursing, Virginia Commonwealth University Health Systems, Richmond, VA 23219, USA.
Cancer Nurs. 2013 Jan-Feb;36(1):60-71. doi: 10.1097/NCC.0b013e318250da1a.
Chemotherapy is frequently administered in repetitive cycles. Adolescents with cancer have multiple symptoms related to chemotherapy, but knowledge of symptom trajectories across a cycle is limited. Examining trajectories over a cycle may reveal key periods to manage symptoms.
The aims of this pilot were to describe the trajectory of symptoms (pain, sleep, appetite, nausea, fatigue) and biological and behavioral variables (anxiety, stress, hematologic function) across 1 cycle and examine relationships between variables.
Nine adolescents with cancer within 6 months of diagnosis participated. Data were collected by surveys, chart review, and biologic measures on days 1 and 2 of the cycle, 1 week later (nadir), and day 1 of the following cycle. To evaluate the trajectory, a simple random-effects repeated-measures analysis was computed.
The significant trajectories were fatigue (P = .003), difficulty sleeping (P = .032), and nausea (P = .04). Most of the adolescents reported some anticipatory anxiety about receiving chemotherapy. Significant correlations between symptoms and biobehavioral variables included anticipatory anxiety and nausea (r = .86, P = .003), trait anxiety and fatigue (r = -0.82, P < .001), and stress and pain (r = 0.78, P = .039).
Multiple symptoms were experienced across the cycle. Three symptoms displayed significant trajectories indicating that patterns of symptoms may be anticipated.
Pilot findings suggest that monitoring symptoms, stress, and anxiety across a cycle is important, not only during chemotherapy administration, but also prior to being admitted for chemotherapy.
化疗通常以重复周期的形式进行。患有癌症的青少年有许多与化疗相关的症状，但对一个周期内症状的轨迹知之甚少。研究一个周期内的轨迹可能会发现管理症状的关键时期。
本研究的目的是描述一个周期内（疼痛、睡眠、食欲、恶心、疲劳）症状以及生物和行为变量（焦虑、压力、血液功能）的轨迹，并检验变量之间的关系。
9 名在诊断后 6 个月内的癌症青少年参与了这项研究。数据通过问卷调查、病历回顾和生物测量在周期的第 1 天和第 2 天（第 1 天）、1 周后（最低点）以及下一个周期的第 1 天收集。为了评估轨迹，我们使用简单的随机效应重复测量分析进行计算。
显著的轨迹是疲劳（P =.003）、睡眠困难（P =.032）和恶心（P =.04）。大多数青少年在接受化疗时会感到一些预期性焦虑。症状和生物行为变量之间存在显著相关性，包括预期性焦虑和恶心（r =.86，P =.003）、特质焦虑和疲劳（r = -0.82，P <.001）以及压力和疼痛（r = 0.78，P =.039）。
整个周期内都出现了多种症状。三个症状表现出显著的轨迹，这表明症状的模式可能是可以预测的。
研究结果表明，监测一个周期内的症状、压力和焦虑不仅在化疗期间，而且在入院接受化疗之前都很重要。
