Röttgering Jantine G, Belgers Vera, Kouwenhoven Mathilde C M, Schuur Maaike, Postma Tjeerd J, Nijboer Claudia M, van Linde Myra E, de Witt Hamer Philip C, Douw Linda, Klein Martin
Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, the Netherlands.
Amsterdam UMC Location Vrije Universiteit Amsterdam, Medical Psychology, Boelelaan, 1117, Amsterdam, the Netherlands.
Heliyon. 2023 Jan 26;9(2):e13278. doi: 10.1016/j.heliyon.2023.e13278. eCollection 2023 Feb.
BACKGROUND & AIMS: Glioma patients experience a multitude of symptoms that negatively affect their health-related quality of life. Symptoms vary greatly across disease phases, and the patients' stable phase might be particularly suitable for assessing and treating symptoms. Identifying symptoms and patients' needs is a first step toward improving patient care. In glioma patients with stable disease, we assessed the frequency and burden of patient-reported symptoms, examined how these symptoms co-occur, and also determined whether patients would consider treatment to ameliorate specific symptoms.
In this retrospective study, patients rated the frequency and burden of seventeen symptoms on a seven-point Likert scale and stated whether they would consider treatment for these symptoms. Correlations between frequency, burden, and considering treatment were evaluated with Kendall's Tau correlation coefficients. Based on partial correlations between symptom frequencies we visualized the symptoms as a network.
Fifty-two glioma patients with stable disease were included (31 WHO grade II/III, 21 WHO grade IV). The top five symptoms were fatigue, memory problems, reduced physical fitness, concentration problems, and drowsiness. Fatigue had the highest median frequency (4.5, interquartile range 2.5). Over half of the patients experienced three or more symptoms simultaneously and associations between all symptoms were depicted as a network. Overall, 35% of patients would consider treatment for at least one symptom. The wish to undergo symptom treatment correlated only moderately with symptom frequency and burden (range of correlations 0.24-0.57 and 0.28-0.61, respectively).
Glioma patients with stable disease experience multiple symptoms with a consequently high symptom burden. Despite the high prevalence of symptoms, the inclination for symptom management interventions was relatively low. The most frequent and burdensome symptoms and the way they are interrelated could serve as a roadmap for future research on symptom management in these patients.
胶质瘤患者会出现多种症状，这些症状会对他们与健康相关的生活质量产生负面影响。症状在疾病的不同阶段差异很大，而患者的稳定期可能特别适合评估和治疗症状。识别症状和患者需求是改善患者护理的第一步。在疾病稳定的胶质瘤患者中，我们评估了患者报告症状的频率和负担，研究了这些症状如何同时出现，还确定了患者是否会考虑接受治疗以改善特定症状。
在这项回顾性研究中，患者用七点李克特量表对17种症状的频率和负担进行评分，并说明他们是否会考虑对这些症状进行治疗。使用肯德尔tau相关系数评估频率、负担和考虑治疗之间的相关性。基于症状频率之间的偏相关性，我们将症状可视化为一个网络。
纳入了52例疾病稳定的胶质瘤患者（31例世界卫生组织二级/三级，21例世界卫生组织四级）。排名前五的症状是疲劳、记忆问题、体能下降、注意力不集中和嗜睡。疲劳的中位频率最高（4.5，四分位间距2.5）。超过一半的患者同时经历了三种或更多症状，所有症状之间的关联被描绘为一个网络。总体而言，35%的患者会考虑对至少一种症状进行治疗。接受症状治疗的意愿与症状频率和负担的相关性仅为中等程度（相关性范围分别为0.24 - 0.57和0.28 - 0.61）。
疾病稳定的胶质瘤患者会出现多种症状，因此症状负担较高。尽管症状的患病率很高，但症状管理干预的倾向相对较低。最常见和负担最重的症状以及它们之间的相互关系可以为这些患者未来的症状管理研究提供路线图。
