Miaskowski Christine, Dunn Laura, Ritchie Christine, Paul Steven M, Cooper Bruce, Aouizerat Bradley E, Alexander Kimberly, Skerman Helen, Yates Patsy
School of Nursing, University of California, San Francisco, California, USA.
School of Medicine, University of California, San Francisco, California, USA.
J Pain Symptom Manage. 2015 Jul;50(1):28-37. doi: 10.1016/j.jpainsymman.2014.12.011. Epub 2015 Jan 31.
Cancer patients experience a broad range of physical and psychological symptoms as a result of their disease and its treatment. On average, these patients report 10 unrelieved and co-occurring symptoms.
The aims were to determine if subgroups of oncology outpatients receiving active treatment (n = 582) could be identified based on their distinct experience with 13 commonly occurring symptoms; to determine whether these subgroups differed on select demographic and clinical characteristics; and to determine if these subgroups differed on quality of life (QOL) outcomes.
Demographic, clinical, and symptom data from one Australian and two U.S. studies were combined. Latent class analysis was used to identify patient subgroups with distinct symptom experiences based on self-report data on symptom occurrence using the Memorial Symptom Assessment Scale.
Four distinct latent classes were identified (i.e., all low [28.0%], moderate physical and lower psych [26.3%], moderate physical and higher psych [25.4%], and all high [20.3%]). Age, gender, education, cancer diagnosis, and presence of metastatic disease differentiated among the latent classes. Patients in the all high class had the worst QOL scores.
Findings from this study confirm the large amount of interindividual variability in the symptom experience of oncology patients. The identification of demographic and clinical characteristics that place patients at risk for a higher symptom burden can be used to guide more aggressive and individualized symptom management interventions.
癌症患者由于疾病及其治疗会经历广泛的身体和心理症状。这些患者平均报告有10种未缓解且同时出现的症状。
旨在确定能否根据接受积极治疗的肿瘤门诊患者(n = 582)对13种常见症状的不同体验来识别亚组;确定这些亚组在选定的人口统计学和临床特征上是否存在差异;以及确定这些亚组在生活质量(QOL)结果上是否存在差异。
合并了来自一项澳大利亚研究和两项美国研究的人口统计学、临床和症状数据。使用潜在类别分析,根据使用纪念症状评估量表的症状发生自我报告数据,识别具有不同症状体验的患者亚组。
确定了四个不同的潜在类别(即,所有低[28.0%]、中度身体症状和较低心理症状[26.3%]、中度身体症状和较高心理症状[25.4%]以及所有高[20.3%])。年龄、性别、教育程度、癌症诊断和转移性疾病的存在在潜在类别之间存在差异。所有高类别中的患者生活质量得分最差。
本研究结果证实了肿瘤患者症状体验中存在大量个体差异。识别使患者面临更高症状负担风险的人口统计学和临床特征,可用于指导更积极和个性化的症状管理干预措施。