| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Yennurajalingam, Sriram Kwon, Jung Hye Urbauer, Diana L. Hui, David Reyes-Gibby, Cielito C. Bruera, Eduardo |
| Spatial Coverage |
United States |
| Description |
Author Affiliation: Yennurajalingam S ( Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.); Kwon JH ( Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.); Urbauer DL ( Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.); Hui D ( Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.); Reyes-Gibby CC ( Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.); Bruera E ( Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.) |
| Abstract |
OBJECTIVE: Advanced cancer patients often develop severe physical and psychological symptom clusters (SCs), but limited data exist on their consistency or severity after an outpatient interdisciplinary team consultation led by palliative care specialists. The primary aim of the study was to determine the consistency and severity of SCs in advanced cancer patients in this setting. METHOD: A total of 1373 patients with advanced cancer who were referred to The University of Texas MD Anderson Cancer Center's Outpatient Supportive Care Center between January 2003 and October 2008 with a complete Edmonton Symptom Assessment Scale (ESAS; 0-10 scale) occurred at initial and first follow-up visit were reviewed (median 14 days, range 1-4 weeks). We used a Wilcoxon signed-rank test to determine whether symptoms changed over time, and a principal components factor analysis with varimax rotation to determine SCs at baseline and at first follow-up. The number of factors calculated was determined based upon the number of eigenvalues. RESULTS: The patients' ratings of the following symptoms (mean, SD) at the initial and follow-up visits, respectively, were: fatigue 6.2 (2.3) and 5.7 (2.5, p < 0.0001), pain 5.4 (2.9) and 4.6 (3, p < 0.0001), nausea 2.2 (2.8) and 2.0 (2.6, p < 0.0001), depression 3.0 (2.9) and 2.5 (2.7, p < 0.0001), anxiety 3.4 (3.0) and 2.8 (2.8, p < 0.0001), drowsiness 4.8 (3.1) and 4.4 (3.1, p < 0.0001), dyspnea 3.0 (2.9) and 2.7 (2.8), p < 0.0001), loss of appetite 4.2 (2.7) and 3.9 (2.7, p < 0.0001), sleep disturbances 4.2 (2.6) and 3.8 (2.6, P < 0.0001), and well-being 4.3 (2.5) and 3.9 (2.3, p < 0.0001). Cluster composition differentiated into physical (fatigue, pain, nausea, drowsiness, dyspnea, and loss of appetite) and psychological (anxiety and depression) components at the initial visit, and these two SCs were consistent upon follow-up. SIGNIFICANCE OF RESULTS: We conclude that SCs remain constant between baseline and near-term follow-up but that the severity of those symptoms lessened during that interval. This knowledge may allow palliative care teams to provide more targeted and higher-quality care, but further studies are needed. |
| File Format |
HTM / HTML |
| ISSN |
14789515 |
| Issue Number |
6 |
| Volume Number |
11 |
| e-ISSN |
14789523 |
| Journal |
Palliative and Supportive Care |
| Language |
English |
| Publisher |
Cambridge University Press |
| Publisher Date |
2013-12-01 |
| Publisher Place |
Great Britain (UK) |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Discipline Palliative Care Discipline Psychology Neoplasms Epidemiology Outpatients Statistics & Numerical Data Palliative Care Severity Of Illness Index Sickness Impact Profile Adult Aged Anxiety Cancer Care Facilities Depression Dyspnea Female Humans Male Middle Aged Nausea Therapy Pain Stress, Psychological United States Young Adult Journal Article |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Nursing Clinical Psychology Psychiatry and Mental Health |
