Children's National Health System, The George Washington University, Washington, DC, USA.
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Pain Symptom Manage. 2018 Feb;55(2):359-367. doi: 10.1016/j.jpainsymman.2017.08.021. Epub 2017 Sep 1.
Children in treatment for cancer experience multiple, troubling, and interrelated symptoms. Analyzing the interrelatedness of symptoms and how that changes during treatment could yield clinically relevant patient profiles to guide patient care.
The aims were to identify pediatric profiles with respect to Patient-Reported Outcomes Measurement Information System (PROMIS; U.S. Department of Health and Human Services, National Institutes of Health) symptom measures, changes in profile status throughout a chemotherapy cycle, and if a baseline single-item fatigue measure could significantly predict symptom profile status and its changes.
In a longitudinal, single-site, three data point (T1, T2, and T3) design, children between 8 and 18 years completed the PROMIS Pediatric short form measures for fatigue, depression, anxiety, and pain and one fatigue item from the Symptom Distress Scale. Latent profile analysis and latent transition analysis were conducted.
About 96 children participated; 58.3% were between 13 and 18 years, and 54.2% were males. Two latent profiles (less severe symptoms and severe symptoms) were identified. The prevalence of the severe symptom profile remained relatively unchanged from T1 to T2 but significantly declined at T3. The baseline single-item fatigue score significantly predicted the child's profile membership and its changes.
Children experiencing troubling symptoms during cancer treatment are heterogeneous. With respect to the PROMIS symptom measures, two a priori unknown distinct latent profiles of patients were identified in a course of chemotherapy, and the transitions in the profile status were significantly predicted by a baseline single-item fatigue measure.
接受癌症治疗的儿童会经历多种令人困扰且相互关联的症状。分析症状的相互关系以及治疗过程中这种相互关系的变化，可以为指导患者护理提供具有临床意义的患者特征。
本研究旨在确定儿科患者在患者报告结局测量信息系统（PROMIS；美国卫生与公众服务部，美国国立卫生研究院）症状测量方面的特征，在化疗周期中特征状态的变化，以及基线单项疲劳测量是否可以显著预测症状特征状态及其变化。
采用纵向、单站点、三个时间点（T1、T2 和 T3）设计，8 至 18 岁的儿童完成 PROMIS 儿科短式量表疲劳、抑郁、焦虑和疼痛以及症状困扰量表的一项疲劳条目。进行潜在剖面分析和潜在转变分析。
约 96 名儿童参与了研究；58.3%的儿童年龄在 13 至 18 岁之间，54.2%为男性。确定了两个潜在特征（症状较轻和症状较重）。从 T1 到 T2，严重症状特征的患病率相对保持不变，但在 T3 显著下降。基线单项疲劳评分显著预测儿童的特征分类及其变化。
在癌症治疗期间经历令人困扰的症状的儿童存在异质性。在 PROMIS 症状测量方面，在化疗过程中确定了两个事先未知的患者潜在特征，基线单项疲劳测量显著预测了特征状态的转变。
