Delta Mu, Postdoctoral Fellow, Yale School of Nursing, West Haven, CT, USA.
Research Scientist, Yale School of Nursing, West Haven, CT, USA.
J Nurs Scholarsh. 2018 Sep;50(5):473-481. doi: 10.1111/jnu.12409. Epub 2018 Jul 3.
To describe changes in symptom cluster membership over 1 year and to examine which demographic and clinical factors predict changes in symptom cluster membership among adults with inflammatory bowel disease.
A retrospective longitudinal study of the Crohn's & Colitis Foundation of America Partners Cohort from 2012 to 2015.
We measured symptoms of pain interference, fatigue, sleep disturbance, depression, and anxiety. We used latent transition analysis to describe changes in symptom cluster membership (baseline, 6 months, and 12 months) and multinomial regressions to examine factors associated with symptom cluster membership transition.
Four groups were identified (N = 5,296): high symptom burden (32.3%-35.3%), low symptom burden (24.2%-27.1%), physical symptoms (19.0%-20.9%; pain, fatigue, sleep disturbance), and psychological symptoms (20.0%-21.5%; depression, anxiety). The probability of staying in the same group was .814 to .905. Moving from active disease into remission was associated with moving from the high burden to low burden and psychological symptom groups.
Symptom cluster membership was quite stable over 1 year. Research is needed to understand the underlying etiology of symptom clusters better and to develop interventions to reduce symptom burden in this vulnerable population.
Careful consideration of symptom management options should be done with patients to select options that are effective and potentially target multiple symptoms.
描述炎症性肠病患者在 1 年内症状群成员变化情况，并探讨哪些人口统计学和临床因素可预测症状群成员的变化。
对 2012 年至 2015 年美国克罗恩病和结肠炎基金会合作伙伴队列进行回顾性纵向研究。
我们测量了疼痛干扰、疲劳、睡眠障碍、抑郁和焦虑症状。我们使用潜在转移分析描述症状群成员变化（基线、6 个月和 12 个月），并使用多项回归分析检查与症状群成员转移相关的因素。
共确定了 4 个组（N=5296）：高症状负担（32.3%-35.3%）、低症状负担（24.2%-27.1%）、躯体症状（19.0%-20.9%；疼痛、疲劳、睡眠障碍）和心理症状（20.0%-21.5%；抑郁、焦虑）。同一组的停留概率为.814 至.905。从活动期疾病进入缓解期与从高负担组转移到低负担组和心理症状组有关。
症状群成员在 1 年内相当稳定。需要进一步研究以更好地了解症状群的潜在病因，并为这一脆弱人群开发减轻症状负担的干预措施。
应与患者仔细考虑症状管理选择，以选择有效且可能针对多种症状的选择。
