Dana-Farber Cancer Institute (M.J.H.), Boston, Massachusetts, USA.
School of Nursing (B.C., S.M.P., K.M.K., C.M.), University of California, San Francisco, California, USA.
J Pain Symptom Manage. 2022 Jul;64(1):17-27. doi: 10.1016/j.jpainsymman.2022.03.007. Epub 2022 Mar 25.
Pain, fatigue, sleep disturbance, and depression often co-occur in oncology patients and negatively impact quality of life (QOL).
Study purposes were to identify subgroups of patients with distinct symptom profiles based on their experiences with a pre-specified symptom cluster (i.e., pain, fatigue, depression, sleep disturbance) and to identify demographic, clinical, and symptom characteristics and QOL outcomes associated with each distinct profile.
Patients with breast, lung, gastrointestinal, and gynecologic cancers (n = 1340) were recruited from outpatient clinics during their first or second cycle of chemotherapy. They completed valid and reliable measures of pain, fatigue, sleep disturbance. depression, and QOL prior to their next dose of chemotherapy. Latent class profile analysis was used to identify the patient subgroups. Differences among the profiles were evaluated using parametric and non-parametric tests.
Three distinct profiles were identified (i.e., Low (44.0%), Moderate (45.1%), High (10.8%). Compared to Low class, Moderate and High classes were younger and more likely to be female. Compared to the other two classes, High class was less likely to be married/partnered and employed, more likely to have a lower income and childcare responsibilities, had lower functional status, a higher body mass index, and exercised less. For both QOL scales, differences in subscale and total scores followed the same pattern (Low>Moderate>High).
Over 55% of patients undergoing chemotherapy had a moderate to high symptom burden associated with these four common co-occurring symptoms. Multimodal interventions are needed to decrease symptom burden and improve QOL outcomes in these patients.
疼痛、疲劳、睡眠障碍和抑郁常常在肿瘤患者中同时出现，并对生活质量（QOL）产生负面影响。
本研究旨在根据患者在特定症状群（即疼痛、疲劳、抑郁、睡眠障碍）方面的经历，确定具有不同症状特征的亚组，并确定与每个不同特征相关的人口统计学、临床和症状特征以及 QOL 结局。
从接受首次或第二次化疗的门诊患者中招募了患有乳腺癌、肺癌、胃肠道癌和妇科癌症的患者（n=1340）。他们在接受下一次化疗前完成了疼痛、疲劳、睡眠障碍、抑郁和 QOL 的有效和可靠测量。使用潜在类别剖面分析来确定患者亚组。使用参数和非参数检验评估不同特征之间的差异。
确定了三个不同的特征（即低（44.0%）、中（45.1%）、高（10.8%）。与低特征相比，中特征和高特征更年轻，更可能是女性。与其他两个特征相比，高特征更不可能已婚/有伴侣和有工作，更可能收入较低，有育儿责任，功能状态较低，体重指数较高，锻炼较少。对于两个 QOL 量表，亚量表和总分的差异都遵循相同的模式（低>中>高）。
超过 55%的接受化疗的患者有中度到高度的症状负担，这些症状与这四个常见的共病症状有关。需要采用多模式干预措施来减轻这些患者的症状负担，改善 QOL 结局。
