Dana-Farber Cancer Institute, Boston, MA, USA.
School of Nursing, University of California, San Francisco, San Francisco, CA, USA.
Support Care Cancer. 2023 Jul 22;31(8):485. doi: 10.1007/s00520-023-07954-6.
Pain, fatigue, sleep disturbance, and depression are four of the most common symptoms in patients with gynecologic cancer. The purposes were to identify subgroups of patients with distinct co-occurring pain, fatigue, sleep disturbance, and depression profiles (i.e., pre-specified symptom cluster) in a sample of patients with gynecologic cancer receiving chemotherapy and assess for differences in demographic and clinical characteristics, as well as the severity of other common symptoms and QOL outcomes among these subgroups.
Patients completed symptom questionnaires prior to their second or third cycle of chemotherapy. Latent profile analysis was used to identify subgroups of patients using the pre-specified symptom cluster. Parametric and nonparametric tests were used to evaluate for differences between the subgroups.
In the sample of 233 patients, two distinct latent classes were identified (i.e., low (64.8%) and high (35.2%)) indicating lower and higher levels of symptom burden. Patients in high class were younger, had child care responsibilities, were unemployed, and had a lower annual income. In addition, these women had a higher body mass index, a higher comorbidity burden, and a lower functional status. Patients in the high class reported higher levels of anxiety, as well as lower levels of energy and cognitive function and poorer quality of life scores.
This study identified a number of modifiable and non-modifiable risk factors associated with membership in the high class. Clinicians can use this information to refer patients to dieticians and physical therapists for tailored interventions.
疼痛、疲劳、睡眠障碍和抑郁是妇科癌症患者最常见的四种症状。本研究旨在确定接受化疗的妇科癌症患者样本中存在特定的疼痛、疲劳、睡眠障碍和抑郁共病特征（即预先指定的症状群）的患者亚组，并评估这些亚组在人口统计学和临床特征方面的差异，以及其他常见症状和生活质量结局的严重程度。
患者在接受第二或第三周期化疗前完成症状问卷。使用潜在剖面分析来确定预先指定的症状群的患者亚组。使用参数和非参数检验来评估亚组之间的差异。
在 233 名患者的样本中，确定了两个不同的潜在类别（即低（64.8%）和高（35.2%）），表明症状负担较低和较高。高类别的患者年龄较小，有儿童照顾责任，失业，年收入较低。此外，这些女性的体重指数更高，合并症负担更高，功能状态更低。高类别的患者报告焦虑水平更高，精力和认知功能水平更低，生活质量评分更差。
本研究确定了与高类别的成员身份相关的一些可改变和不可改变的风险因素。临床医生可以利用这些信息为患者转介营养师和物理治疗师，以进行个性化干预。
