Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA.
Department of Acute and Continuing Care, The University of Texas Health Science Center at Houston School of Nursing, 6901 Bertner Avenue, SON-686, Houston, TX, 77030, USA.
Support Care Cancer. 2019 Dec;27(12):4639-4647. doi: 10.1007/s00520-019-04770-9. Epub 2019 Apr 2.
The American Cancer Society predicted that 266,120 women would be diagnosed with breast cancer in 2018. Women experience significant symptom burden in response to tumor and treatment-related adverse effects, particularly in advanced disease. Use of valid and reliable patient-reported outcomes (PRO) symptom measures may assist clinicians in systematically monitoring and managing symptoms. The MD Anderson Symptom Inventory (MDASI) is a brief PRO measure of cancer symptom burden; specific symptoms can be added to the core symptoms to produce disease- and treatment-specific modules. The purpose of this study was to describe the patient symptom experience, define the content domain, and generate items for a breast cancer-specific MDASI module for measuring symptom burden in women with breast cancer.
Women with breast cancer were qualitatively interviewed about their experiences of disease and treatment. Descriptive exploratory analysis identified symptoms and symptom interference to define the symptom burden of breast cancer. An expert panel rated the relevance of the identified symptoms to patients with breast cancer.
A conceptual model of breast cancer symptom burden was developed from interviews with 36 women (mean age of 57.9 years, 86.1% had stages I-III, and 52.8% were on chemotherapy and/or radiation therapy) across the breast cancer disease and treatment trajectory. Thirty-six symptoms and 6 interference categories were identified. Symptoms specific to treatment modalities and breast cancer met the criteria for inclusion in the provisional instrument for psychometric testing.
We generated an instrument with content validity for measuring symptom burden specific to women with breast cancer.
美国癌症协会预测，2018 年将有 266,120 名女性被诊断患有乳腺癌。女性在应对肿瘤和治疗相关不良反应时会承受严重的症状负担，尤其是在晚期疾病中。使用有效和可靠的患者报告结局（PRO）症状测量工具可能有助于临床医生系统地监测和管理症状。MD 安德森症状量表（MDASI）是一种简短的癌症症状负担 PRO 测量工具；可以在核心症状中添加特定症状，以生成针对特定疾病和治疗的模块。本研究的目的是描述患者的症状体验，定义内容领域，并为乳腺癌特异性 MDASI 模块生成用于测量乳腺癌女性症状负担的项目。
对患有乳腺癌的女性进行定性访谈，了解她们的疾病和治疗经历。描述性探索性分析确定了症状和症状干扰，以定义乳腺癌的症状负担。一个专家小组对确定的与乳腺癌患者相关的症状进行了评估。
从 36 名女性（平均年龄 57.9 岁，86.1%为 I-III 期，52.8%正在接受化疗和/或放疗）的访谈中开发了一个乳腺癌症状负担的概念模型，涵盖了乳腺癌疾病和治疗的整个过程。确定了 36 种症状和 6 种干扰类别。针对治疗方式和乳腺癌的特定症状符合纳入暂定工具进行心理测量测试的标准。
我们生成了一种具有内容效度的工具，用于测量女性乳腺癌特有的症状负担。
