2.50
Hdl Handle:
http://hdl.handle.net/10755/157942
Type:
Presentation
Title:
Patient-Centered Symptom Clusters in Patients Receiving Biological Therapies
Abstract:
Patient-Centered Symptom Clusters in Patients Receiving Biological Therapies
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Cho, Maria, RN, PhD
P.I. Institution Name:University of California San Francisco, Physiological Nursing
Title:Assistant Adjunct Professor
Contact Address:2 Koret Way, Box 0610, San Francisco, CA, 94143, USA
Contact Telephone:415-476-6975
Co-Authors:Bruce Cooper, Associate Adjunct Professor; Marylin Dodd, Professor Emerita; Christine Miaskowski, Professor; Judy Petersen, RN, MN, Director of Clinical Development and Clinical Specialist, Oncology
Purpose: The purpose of this study is to identify subgroups (classes) of patients with different symptom experiences while receiving biological therapies, and examine subgroup membership stability and change from T1 (at first dose of biologic therapy) to T2 (a month later), and to compare the subgroups on quality of life (QOL) and functional status (Karnofsky Performance Scale: KPS).  Rationale/conceptual Basis/Background: Despite an increasing body of literature on cancer  treatment-related symptom clusters, and their negative impact on quality of life, no study has reported patient-centered symptom clusters and quality of life in patients receiving biotherapy over time. Concept Development (Meleis, 1997) was used. Methods: Descriptive, prospective, cohort study design was used in an internet online survey. At T1, 188 patients with various types of cancer received biotherapies. The mean age was 52 years (SD=10.56), 83% were women, 100% had at least high school education, 76% were married, 54% worked full or part time, and 93% were Caucasian. At T2, 114 subjects returned to the online survey, and the demographic characteristics for this group were similar. The Piper Fatigue Scale, General Sleep Disturbance Scale, CES-Depression, a numeric rating scale of worst pain intensity, QOL-CA, and KPS were used. Internal consistency of all instruments ranged from .87 to .97. Latent transition analysis was used for determining group membership changes from T1 to T2. Results: Three patient subgroups at T1 and two patient subgroups at T2 showed a statistically stable and significant model. The matrix of transition created six distinct patient subgroups:(1) mild pain and fatigue; (2) mild pain, fatigue, and sleep disturbance; (3) mild pain, moderate fatigue, sleep disturbance, and depression;(4) moderate pain, fatigue, sleep disturbance, and depression; (5) high severities on all four symptoms; (6) high severities on all symptoms with moderate  pain. The notable findings were the patients who classified to the (5) and (6) subgroups who had low quality of life scores (range 3.5 to 4.7 QOL). The patient subgroups with greater than moderate severity of all four symptoms subgroups (4, 5, and 6) showed lower functional status (range 63% to 76% KPS) than the other patient subgroups (range 85% to 95% KPS). Implications: Patients receiving biological therapy reported similar or even higher symptom scores than patients receiving chemotherapy +/- radiation therapy. Subgroups of patients who had high severity of the four symptoms need an assessment of their symptoms and an intervention to improve their QOL and functional status over time.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatient-Centered Symptom Clusters in Patients Receiving Biological Therapiesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157942-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patient-Centered Symptom Clusters in Patients Receiving Biological Therapies</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cho, Maria, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California San Francisco, Physiological Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Adjunct Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2 Koret Way, Box 0610, San Francisco, CA, 94143, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">415-476-6975</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">maria.cho@nursing.ucsf.edu, joshlizmykids@yahoo.co</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Bruce Cooper, Associate Adjunct Professor; Marylin Dodd, Professor Emerita; Christine Miaskowski, Professor; Judy Petersen, RN, MN, Director of Clinical Development and Clinical Specialist, Oncology</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this study is to identify subgroups (classes) of patients with different symptom experiences while receiving biological therapies, and examine subgroup membership stability and change from T1 (at first dose of biologic therapy) to T2 (a month later), and to compare the subgroups on quality of life (QOL) and functional status (Karnofsky Performance Scale: KPS). &nbsp;Rationale/conceptual Basis/Background: Despite an increasing body of literature on cancer&nbsp; treatment-related symptom clusters, and their negative impact on quality of life, no study has reported patient-centered symptom clusters and quality of life in patients receiving biotherapy over time. Concept Development (Meleis, 1997) was used. Methods: Descriptive, prospective, cohort study design was used in an internet online survey. At T1, 188 patients with various types of cancer received biotherapies. The mean age was 52 years (SD=10.56), 83% were women, 100% had at least high school education, 76% were married, 54% worked full or part time, and 93% were Caucasian. At T2, 114 subjects returned to the online survey, and the demographic characteristics for this group were similar. The Piper Fatigue Scale, General Sleep Disturbance Scale, CES-Depression, a numeric rating scale of worst pain intensity, QOL-CA, and KPS were used. Internal consistency of all instruments ranged from .87 to .97. Latent transition analysis was used for determining group membership changes from T1 to T2. Results: Three patient subgroups at T1 and two patient subgroups at T2 showed a statistically stable and significant model. The matrix of transition created six distinct patient subgroups:(1) mild pain and fatigue; (2) mild pain, fatigue, and sleep disturbance; (3) mild pain, moderate fatigue, sleep disturbance, and depression;(4) moderate pain, fatigue, sleep disturbance, and depression; (5) high severities on all four symptoms; (6) high severities on all symptoms with moderate &nbsp;pain. The notable findings were the patients who classified to the (5) and (6) subgroups who had low quality of life scores (range 3.5 to 4.7 QOL). The patient subgroups with greater than moderate severity of all four symptoms subgroups (4, 5, and 6) showed lower functional status (range 63% to 76% KPS) than the other patient subgroups (range 85% to 95% KPS).&nbsp;Implications: Patients receiving biological therapy reported similar or even higher symptom scores than patients receiving chemotherapy +/- radiation therapy. Subgroups of patients who had high severity of the four symptoms need an assessment of their symptoms and an intervention to improve their QOL and functional status over time.</td></tr></table>en_GB
dc.date.available2011-10-26T20:21:14Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:21:14Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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