Symptoms experienced by cancer patients during the first year from diagnosis: Patient and informal caregiver ratings and agreement

2010 ◽  
Vol 8 (3) ◽  
pp. 313-324 ◽  
Author(s):  
Alexander Molassiotis ◽  
Y. Zheng ◽  
L. Denton-Cardew ◽  
R. Swindell ◽  
L. Brunton
Keyword(s):  
Symptom Assessment ◽  
First Year ◽  
Symptom Experience ◽  
Patients With Cancer ◽  
Moderate Agreement ◽  
Memorial Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Prospective Longitudinal ◽  
Over Time

AbstractObjective:The aim of this study was to explore the symptom experience of patients with cancer, identify changes in symptoms over time, and explore the congruence of symptom reports between patients and their informal caregivers.Method:This was a prospective longitudinal evaluation of symptoms over 1 year from start of treatments (T1) using the Memorial Symptom Assessment Scale. Assessments and follow up took place at 3 months (T2), 6 months (T3) and 12 months (T4). A heterogeneous sample of 100 patients with cancer participated, providing 325 assessments over time. Furthermore, 82 caregivers also participated, providing 238 dyadic patient–caregiver assessments over the same time.Results:The most commonly occurring, and by far most distressing, symptom was “lack of energy.” Common symptoms reported were lack of concentration, difficulties sleeping, shortness of breath, cough, pain, dry mouth, and feeling drowsy. Symptom occurrence and distress improved over time, particularly from T2 to T3 (p < 0.05), but the “chronicity” of some generic symptoms was notable. Caregivers tended to overestimate occurrence and distress compared to patients, particularly in symptoms of psychological nature; κ statistics had a highest coefficient of 0.45, suggesting moderate agreement between patients and caregivers at best.Significance of results:More attention needs to be paid to the commonly reported symptoms by patients, as they have the potential of impacting on quality of life (QOL). As patient–caregiver reports had moderate agreement, effort should be directed to improving this agreement, as caregivers are often communicating patient symptoms to clinicians.

Symptom clustering among patients visiting a supportive oncology clinic.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 188-188 ◽  
Author(s):  
Kathryn C. Wrammert ◽  
Gwendolynn Harrell ◽  
Michael O'Neill ◽  
Anjali Grandhige ◽  
Danielle Moulia ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Hierarchical Cluster ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Cancer Symptoms ◽  
Patients With Cancer ◽  
Memorial Symptom Assessment Scale ◽  
Supportive Oncology ◽  
Symptom Assessment Scale ◽  
Absolute Correlation

188 Background: Multiple symptoms are common and often severe in patients with cancer. Identification of symptoms which cluster may serve to elucidate the pathophysiology of the disease and aid in symptom management. Our aim was to define symptom clusters occurring among cancer outpatients receiving chemotherapy. Methods: New and returning patients referred to a supportive oncology clinic (SOC) from our health system’s oncologists from November 2011 through May 2014 completed the Condensed Memorial Symptom Assessment Scale plus a sexual dysfunction structured assessment. Data were collected prospectively from 323 consecutive initial visits. Patients rated from 0-4 how bothersome 15 cancer symptoms were; symptoms were then graded as present (1+) or absent (0). Hierarchical cluster analysis with average linkage was used to identify symptom clusters. The absolute value of the correlation between symptoms was used as the measure of similarity between pairs of symptoms. A correlation of ≥0.6 was used to define the final clusters. A symptom cluster was defined as two or more symptoms that predictably occur together. Results: Three clusters were identified: 1. Psychological (worrying, feeling sad, feeling nervous); 2. Treatment-related (lack of energy, feeling drowsy, difficulty concentrating, dry mouth, constipation); 3. Gastrointestinal (weight loss, lack of appetite, nausea). Pain, difficulty sleeping, shortness of breath, and loss of interest did not cluster with any symptom. Gastrointestinal symptoms are important within the clusters. The prevalence of worrying, feeling sad, and feeling nervous did not cluster with lack of energy or difficulty in sleeping, nor pain with worrying or feeling sad. Conclusions: Three symptom clusters were identified as showing high absolute correlation: a psychological cluster, treatment-related cluster, and gastrointestinal cluster. Identifying symptom clusters may promote our understanding of the pathophysiology of cancer, help prioritize effective pharmacotherapies, and identify drugs likely to help more than one symptom.

Stability of symptom clusters in patients with gastrointestinal cancers receiving chemotherapy.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 193-193
Author(s):  
Claire J. Han ◽  
Kerryn Reding ◽  
Bruce A. Cooper ◽  
Steven M. Paul ◽  
Yvette Conley ◽  
...  
Keyword(s):  
Weight Change ◽  
Management Strategies ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Symptom Dimensions ◽  
Memorial Symptom Assessment Scale ◽  
Exploratory Factor Analyses ◽  
Gi Cancers ◽  
Symptom Assessment Scale ◽  
Over Time

193 Background: Patients with gastrointestinal (GI) cancers who undergo chemotherapy (CTX) experience on average of thirteen symptoms. These co-occurring symptoms often cluster together and can influence various patient outcomes including quality of life (QOL). However, little evidence is available on how these symptoms change during a cycle of chemotherapy (CTX). An evaluation of how these symptom cluster together and how these symptom clusters change over time may provide useful information to guide symptom management strategies tailored to multiple symptoms. Objectives: The purpose of this study was to identify and compare symptom clusters using three symptom dimensions (i.e., occurrence, severity, and distress) at different time points during CTX (i.e., prior to CTX [T1], one week after CTX administration [T2], and two weeks after CTX administration [T3]) in patients with GI cancers. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms. Exploratory factor analyses were used to create the symptom clusters. Results: Five distinct symptom clusters were identified across the three symptom dimensions and the three assessments (i.e., psychological, CTX-related, weight change, GI, and epithelial). Psychological, CTX-related and weight change clusters were relatively stable for all three symptom dimensions as well as across time. GI cluster was identified only at T1, while epithelial cluster was identified at T2 and T3 for all three symptom dimensions. Conclusions: The number and types of symptom clusters appear to be relatively stable over time and across the symptom dimensions. Timely management of symptom clusters should be continued over the course of CTX including the recovery phases. Further studies are needed to explore the mechanisms of symptom clusters in patients with GI cancers undergoing CTX.

scholarly journals Are the Most Distressing Concerns of Patients With Inoperable Lung Cancer Adequately Assessed? A Mixed-Methods Analysis

2010 ◽  
Vol 28 (11) ◽  
pp. 1942-1949 ◽  
Author(s):  
Carol Tishelman ◽  
Malin Lövgren ◽  
Eva Broberger ◽  
Katarina Hamberg ◽  
Mirjam A.G. Sprangers
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Psychosocial Problems ◽  
Symptom Assessment ◽  
First Year ◽  
Life Questionnaire ◽  
Distress Screening ◽  
Patient Reported ◽  
Symptom Assessment Scale

Purpose Standardized questionnaires for patient-reported outcomes are generally composed of specified predetermined items, although other areas may also cause patients distress. We therefore studied reports of what was most distressing for 343 patients with inoperable lung cancer (LC) at six time points during the first year postdiagnosis and how these concerns were assessed by three quality-of-life and symptom questionnaires. Patients and Methods Qualitative analysis of patients' responses to the question “What do you find most distressing at present?” generated 20 categories, with 17 under the dimensions of “bodily distress,” “life situation with LC,” and “iatrogenic distress.” Descriptive and inferential statistical analyses were conducted. Results The majority of statements reported as most distressing related to somatic and psychosocial problems, with 26% of patients reporting an overarching form of distress instead of specific problems at some time point. Twenty-seven percent reported some facet of their contact with the health care system as causing them most distress. While 55% to 59% of concerns reported as most distressing were clearly assessed by the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire Core-30 and Lung Cancer Module instruments, the Memorial Symptom Assessment Scale, and the modified Distress Screening Tool, iatrogenic distress is not specifically targeted by any of the three instruments examined. Conclusion Using this approach, several distressing issues were found to be commonly reported by this patient group but were not assessed by standardized questionnaires. This highlights the need to carefully consider choice of instrument in relation to study objectives and characteristics of the sample investigated and to consider complementary means of assessment in clinical practice.

Equivalência semântica da versão em português do instrumento Memorial Symptom Assessment Scale (MSAS) para avaliar sintomas em pacientes oncológicos

1969 ◽  
Vol 19 (2) ◽  
pp. 83-91 ◽  
Author(s):  
Larissa Fernandes Da Rocha ◽  
Monique da Silva Carvalho ◽  
Ana Amélia Moraes de Lacerda ◽  
Áila Ferreira Vizeu Viana ◽  
Raquel de Souza Ramos ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Symptom Assessment ◽  
Assessment Scale ◽  
Semantic Equivalence ◽  
Portuguese Version ◽  
Memorial Symptom Assessment Scale ◽  
Symptom Assessment Scale

Semantic equivalence of the Portuguese version ofthe Memorial Symptom Assessment Scale (MSAS) to evaluate symptoms in cancer patients

Trajectory of Performance Status and Symptom Scores for Patients With Cancer During the Last Six Months of Life

2011 ◽  
Vol 29 (9) ◽  
pp. 1151-1158 ◽  
Author(s):  
Hsien Seow ◽  
Lisa Barbera ◽  
Rinku Sutradhar ◽  
Doris Howell ◽  
Deborah Dudgeon ◽  
...  
Keyword(s):  
Performance Status ◽  
Symptom Assessment ◽  
Well Being ◽  
Assessment System ◽  
Assessment Tools ◽  
Future Research ◽  
Patients With Cancer ◽  
Average Pain ◽  
Observational Cohort ◽  
Over Time

Purpose Ontario's cancer system is unique because it has implemented two standardized assessment tools population-wide to improve care: the Edmonton Symptom Assessment System (ESAS) measures severity of nine symptoms (scale 0 to 10; 10 indicates the worst) and the Palliative Performance Scale (PPS) measures performance status (scale 0 to 100; 0 indicates death). This article describes the trajectory of ESAS and PPS scores 6 months before death. Patients and Methods Observational cohort study of cancer decedents between 2007 and 2009. Decedents required ≥1 ESAS or PPS assessment in the 6 months before death for inclusion. Outcomes were the decedents' average ESAS and PPS scores per week before death. Results Ten thousand seven hundred fifty-two (ESAS) and 7,882 (PPS) decedents were included. The mean age was 65 years, half were female, and approximately 75% of assessments occurred in cancer clinics. Average PPS score declined slowly over the 6 months before death, starting at approximately 70 and ending at 40, declining more rapidly in the last month. For ESAS symptoms, average pain, nausea, anxiety, and depression scores remained relatively stable over the 6 months. Conversely, shortness of breath, drowsiness, well-being, lack of appetite, and tiredness increased in severity over time, particularly in the month before death. More than one third of the cohort reported moderate to severe scores (ie, 4 to 10) for most symptoms in the last month of life. Conclusion In this large outpatient cancer population, trajectories of mean ESAS scores followed two patterns: increasing versus generally flat. The latter was perhaps due to available treatment (eg, prescriptions) for those symptoms. Future research should prioritize addressing symptoms that worsen over time.

scholarly journals Symptoms and symptom clusters in adolescents with cancer

2021 ◽  
Vol 5 (2) ◽  
pp. 14-24
Author(s):  
Remziye Semerci ◽  
Melahat Akgunmela Kostak ◽  
Tuba Eren ◽  
Filiz Savran ◽  
Gulcan Avci
Keyword(s):  
Symptom Assessment ◽  
Paediatric Oncology ◽  
Symptom Clusters ◽  
Emotional Symptoms ◽  
Purposeful Sampling ◽  
Memorial Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Cancer Experience ◽  
Oncology Unit ◽  
Adolescent Inpatients

Abstract Clinical specialists have suggested that adolescents with cancer experience multiple problems including physical, psychological, and emotional symptoms. This study aimed to identify symptoms and symptoms clusters among adolescent inpatients and outpatients receiving cancer treatment. The study’s sample consisted of 26 adolescents who were selected with the purposeful sampling method in a paediatric oncology unit in Edirne, Turkey. Data were collected using the Memorial Symptom Assessment Scale (MSAS). From the results of the research, in terms of symptoms, outpatients reported a greater lack of concentration than inpatients did. Inpatients reported more hair loss and weight loss symptoms than outpatients. Adolescent inpatients and outpatients experienced the most symptoms during the treatment. Inpatient adolescents experienced more acute treatment-related symptoms than did outpatients. The study recommends regular monitoring and screening for nurses to identify symptom and symptom clusters. Keywords: Adolescent; nursing; symptom cluster; symptom assessment; cancer;  

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