Author Affiliations: Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute (Drs Pozzar and Hammer), Boston, Massachusetts; School of Nursing (Drs Cooper, Kober, Paul, and Miaskowski) and School of Medicine, University of California, San Francisco (Drs Chen, Levine, and Miaskowski); School of Nursing, University of Pittsburgh (Dr Conley), Pennsylvania; Mount Sinai Medical Center (Dr Cartwright), New York, New York; and Rory Myers College of Nursing, New York University (Dr Wright), New York.
Cancer Nurs. 2022;45(4):E706-E718. doi: 10.1097/NCC.0000000000000988. Epub 2021 Sep 23.
Patients with gynecologic cancer undergoing chemotherapy experience multiple co-occurring symptoms. Understanding how symptom clusters change over time is essential to the development of interventions that target multiple co-occurring symptoms.
The aim of this study was to assess the relative stability of symptom clusters across a chemotherapy cycle in patients with gynecologic cancer.
This is a longitudinal, descriptive study. Eligible patients (n = 232) were English-speaking adults (≥18 years old) with gynecologic cancer. Data were collected in the week before patients' second or third cycle of chemotherapy (T1) and at 1 (T2) and 2 (T3) weeks after chemotherapy. Three dimensions of the symptom experience (occurrence, severity, and distress) were assessed using a modified version of the Memorial Symptom Assessment Scale. Symptom clusters for each dimension and time point were identified through exploratory factor analysis.
A 5-factor solution was selected for each exploratory factor analysis. Hormonal, respiratory, and weight change clusters were identified across all dimensions and time points. A psychological symptom cluster was identified at T1 for occurrence and severity and at T2 and T3 for all 3 dimensions. A gastrointestinal symptom cluster was identified at T1 for occurrence and at T2 and T3 for all 3 dimensions. The hormonal, respiratory, psychological, and weight change symptom clusters exhibited common symptoms across dimensions and time points.
Hormonal, respiratory, weight change, and psychological symptom clusters are relatively stable across a cycle of chemotherapy in patients with gynecologic cancer.
Clinicians need to assess patients for multiple co-occurring symptoms and initiate multimodal interventions.
接受化疗的妇科癌症患者会出现多种并存症状。了解症状群随时间的变化对于开发针对多种并存症状的干预措施至关重要。
本研究旨在评估妇科癌症患者化疗周期中症状群的相对稳定性。
这是一项纵向描述性研究。符合条件的患者（n=232）为讲英语的成年女性（≥18 岁），患有妇科癌症。数据采集于患者第二次或第三次化疗周期前一周（T1）以及化疗后 1 周（T2）和 2 周（T3）。使用改良后的 Memorial 症状评估量表评估症状体验的三个维度（发生、严重程度和困扰）。通过探索性因子分析确定每个维度和时间点的症状群。
每个探索性因子分析均选择了 5 因子解决方案。在所有维度和时间点都确定了激素、呼吸和体重变化群。在 T1 时确定了心理症状群，在 T2 和 T3 时确定了所有 3 个维度的心理症状群。在 T1 时确定了胃肠道症状群，在 T2 和 T3 时确定了所有 3 个维度的胃肠道症状群。激素、呼吸、心理和体重变化症状群在多个维度和时间点上表现出共同的症状。
在妇科癌症患者的化疗周期中，激素、呼吸、体重变化和心理症状群相对稳定。
临床医生需要评估患者的多种并存症状并启动多模式干预措施。
