Hamash Kawther Ismail, Umberger Wendy, Aktas Aynur, Walsh Declan, Cheruvu Vinay K
From the Nursing Department, Indiana University-Fort Wayne (IUFW), Fort Wayne, IN, USA.
College of Nursing, Kent State University, Kent, OH, USA.
Pain Manag Nurs. 2018 Dec;19(6):627-636. doi: 10.1016/j.pmn.2018.05.002. Epub 2018 Jun 21.
Pain, depression, anxiety, sleep disturbances, and constipation were reported in different symptom clusters at different stages of breast cancer. Managing symptom clusters rather than individual symptoms can improve performance status.
The study examined the effect of pain symptom cluster (pain and constipation) on performance when mediated by the psychoneurological symptom cluster (depression, anxiety, and sleep disturbances) using age as a moderator.
A secondary analysis.
Palliative care center at a tertiary medical center in northeast Ohio.
Eighty-six women diagnosed with advanced breast cancer.
A quantitative cross-sectional approach.
Ordinal logistic regression showed that pain symptom cluster did not have a significant mediation effect on performance. Odds ratio indicated that subjects with pain symptom cluster were 63% more likely to be bedridden (odds ratio = 1.63, confidence interval = .69-3.84). Women who reported pain symptom cluster were 5% more likely to have psychoneurological symptom cluster (odds ratio = 1.05, confidence interval = .400-2.774). Stratified analysis of age showed no differences in performance. Post-hoc analysis showed that the components of pain symptom cluster had a significant effect on psychoneurological symptom cluster (odds ratio: 3 [1.18-7.62]).
Pain, constipation, depression, anxiety, and sleep disturbances were highly prevalent in women with advanced breast cancer. However, they tended to cluster in different symptom clusters. Although some findings were not significant, they all supported the direction of the tested hypotheses. Variations in symptom clusters research, including methodology, instruments, statistical tests, and chosen symptom cluster correlation coefficient, should be addressed.
乳腺癌不同阶段的不同症状群中均有疼痛、抑郁、焦虑、睡眠障碍和便秘的报告。管理症状群而非个体症状可改善功能状态。
本研究以年龄作为调节变量，考察疼痛症状群（疼痛和便秘）在由心理神经症状群（抑郁、焦虑和睡眠障碍）介导时对功能的影响。
二次分析。
俄亥俄州东北部一家三级医疗中心的姑息治疗中心。
86名被诊断为晚期乳腺癌的女性。
定量横断面研究方法。
有序逻辑回归显示，疼痛症状群对功能没有显著的中介作用。优势比表明，有疼痛症状群的受试者卧床不起的可能性高63%（优势比=1.63，置信区间=.69-3.84）。报告有疼痛症状群的女性出现心理神经症状群的可能性高5%（优势比=1.05，置信区间=.400-2.774）。年龄分层分析显示功能无差异。事后分析表明，疼痛症状群的组成部分对心理神经症状群有显著影响（优势比：3[1.18-7.62]）。
疼痛、便秘、抑郁、焦虑和睡眠障碍在晚期乳腺癌女性中非常普遍。然而，它们往往聚集在不同的症状群中。尽管一些结果不显著，但都支持所检验假设的方向。应解决症状群研究中的差异，包括方法、工具、统计检验和所选症状群相关系数。
