Gilbertson-White Stephanie, Perkhounkova Yelena, Saeidzadeh Seyedehtanaz, Hein Maria, Dahl Rachel, Simons-Burnett Andrean
University of Iowa.
Oncol Nurs Forum. 2019 Jul 1;46(4):428-441. doi: 10.1188/19.ONF.428-441.
To evaluate the feasibility of using a biobehavioral approach to examine symptom burden in rural residents with advanced cancer.
SAMPLE & SETTING: 21 patients with advanced lung, colorectal, or pancreatic cancer were enrolled at the University of Iowa in Iowa City.
METHODS & VARIABLES: Using Cleeland's cytokine-immunologic model of symptom expression, symptom burden (i.e., severity, count, and interference) and inflammatory cytokines were measured for 24 weeks. Potential predictors included demographics, clinical characteristics, optimism, social support, and cancer-related stress. Descriptive statistics, Wilcoxon rank-sum, and Fisher's exact test were used for analysis.
Recruitment and retention rates were similar for rural and nonrural patients. Demographics, optimism, and social support were no different between groups. The cancer-related stress total score for rural patients was nearly half of the score of nonrural patients, with rural patients reporting significantly less avoidance. Symptom severity for the five worst symptoms remained moderate during the 24 weeks, whereas nonrural residents reported steady declines in severity of their five worst symptoms. Significant differences in inflammatory cytokines between groups were only found at one time point.
Rural residents who seek care at a cancer center may be clinically and demographically more similar to their nonrural counterparts than to rural residents seeking local care.
评估采用生物行为学方法检查晚期癌症农村居民症状负担的可行性。
21例晚期肺癌、结直肠癌或胰腺癌患者在爱荷华大学所在的爱荷华市入组。
采用克利兰德症状表达的细胞因子 - 免疫模型，对症状负担（即严重程度、数量和干扰程度）及炎性细胞因子进行为期24周的测量。潜在预测因素包括人口统计学特征、临床特征、乐观程度、社会支持和癌症相关压力。采用描述性统计、威尔科克森秩和检验及费舍尔精确检验进行分析。
农村和非农村患者的招募率和留存率相似。两组间的人口统计学特征、乐观程度和社会支持无差异。农村患者的癌症相关压力总分几乎是非农村患者的一半，农村患者报告的回避行为明显更少。在24周内，五种最严重症状的症状严重程度保持中度，而非农村居民报告其五种最严重症状的严重程度持续下降。两组间炎性细胞因子仅在一个时间点存在显著差异。
在癌症中心寻求治疗的农村居民在临床和人口统计学方面可能与其非农村同行更为相似，而非与寻求当地治疗的农村居民相似。
