College of Nursing, Catholic University of Korea, Seoul, South Korea.
Malone Quantitative, Durham, NC, USA.
Eur J Oncol Nurs. 2019 Oct;42:97-102. doi: 10.1016/j.ejon.2019.08.005. Epub 2019 Aug 15.
(a) To identify subgroups with unique psychoneurological symptom-cluster experience (depression, cognitive impairment, fatigue, sleep disturbance, and pain) and (b) to examine whether the selected demographic, clinical, psychological, and biological factors determine a symptom-cluster experience in cancer patients.
The sample included 203 patients with diverse cancer types recruited from a Korean university hospital. Latent profile analyses were conducted to identify subgroups. Influencing factors of subgroup membership (demographic/clinical variables, hemoglobin level, social support, and psychological stress) were included as covariates in latent profile analysis and analyzed by multinomial logistic regression.
Latent profile analyses classified patients into two subgroups with a unique symptom cluster experience: patients experiencing high intensity in all symptoms within the cluster (the all-high-symptom subgroup, 71%) and patients experiencing low intensity in all symptoms within the cluster (all-low-symptom subgroup, 29%). The validity of the two subgroups was confirmed by the group classification accuracy (97% of the all-low-symptom subgroup and 99% of the all-high-symptom subgroup) and by significant Wald's mean equality tests, showing each symptom (depression, cognitive impairment, fatigue, sleep disturbance, and pain) significantly differentiated the two subgroups (ps < .001). Psychological stress independently determined the subgroup membership. Patients with high levels of stress were more likely to be in the all-high-symptom group (OR = 4.69, p < .0001). Hemoglobin level, cancer diagnosis, social support, and previous chemotherapy experience did not influence group membership.
A large number of patients experience five psychoneurological symptoms simultaneously due to psychological stress. Interventions targeted to stress would be beneficial for those patients.
(a) 确定具有独特心理神经症状群体验（抑郁、认知障碍、疲劳、睡眠障碍和疼痛）的亚组；(b) 检验所选人口统计学、临床、心理和生物学因素是否决定癌症患者的症状群体验。
本研究样本包括来自韩国一所大学医院的 203 名不同癌症类型的患者。采用潜在剖面分析来确定亚组。将影响亚组成员身份的因素（人口统计学/临床变量、血红蛋白水平、社会支持和心理压力）作为协变量纳入潜在剖面分析，并通过多项逻辑回归进行分析。
潜在剖面分析将患者分为具有独特症状群体验的两个亚组：所有症状均高度体验（所有高症状亚组，71%）和所有症状均低度体验（所有低症状亚组，29%）。两个亚组的有效性通过组分类准确性（所有低症状亚组为 97%，所有高症状亚组为 99%）和显著的 Wald 均值相等检验得到证实，表明每个症状（抑郁、认知障碍、疲劳、睡眠障碍和疼痛）均显著区分两个亚组（p<.001）。心理压力独立决定亚组成员身份。高水平压力的患者更有可能属于所有高症状组（OR=4.69，p<.0001）。血红蛋白水平、癌症诊断、社会支持和既往化疗经历均不影响分组。
大量患者因心理压力同时出现五种心理神经症状。针对压力的干预措施对这些患者可能有益。
