Kurtz M E, Given B, Kurtz J C, Given C W
College of Human Medicine, Department of Family Medicine, Michigan State University, East Lansing.
Cancer. 1994 Oct 1;74(7 Suppl):2071-8. doi: 10.1002/1097-0142(19941001)74:7+<2071::aid-cncr2820741715>3.0.co;2-r.
During the course of cancer treatment and as the disease progresses, symptoms may worsen and physical status may deteriorate. The interaction of age, symptoms, and nearness to death on the physical and mental health of patients and family members has not been examined. The research questions in this paper focus on how age and survival status influence the frequency and severity of patients' symptoms and dependencies in functioning. The impact of patient age and survival status on family depression, schedule, and health also are explored.
Cancer patients in treatment and their caregiver dyads (n = 208) were followed for 12 months. Survival status was measured by those who survived the year, those who died within 6 months, and those who died between 6 and 12 months. Measures used included frequency and severity counts of patient symptoms, functioning (activities of daily living [ADL] and immobility), depression, frequency of others' assistance to caregivers, and caregiver reactions to care. Analysis of variance was applied to test for significant differences according to age and survival status.
Symptoms did vary significantly by survival status; however, age demonstrated no independent effect on patient variables including: symptom severity, patient depression, and ADL or immobility. When controlling for symptom severity and age, survival group had no effect on ADL status. For immobility, survival status continued to have a direct impact. Survival status does not influence dependencies in ADL but is related directly to losses in mobility. Significant differences occurred by survival groups for caregiver depression, caregiver reactions, and patient assistance.
Strategies for assisting patients and families to deal with immobility are important. Family members require assistance for their distress as patient status deteriorates.
