Comparison of subgroups of breast cancer patients on pain and co-occurring symptoms following chemotherapy (original) (raw)
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Supportive Care in Cancer, 2019
Purpose Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods Participants were 152 women with stage I-IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint. Results Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2. Conclusions This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden.
Assessing the impact of pain on the life of breast cancer survivors using the Brief Pain Inventory
[Purpose] This study attempted to assess the impact of pain on the life of breast cancer survivors using the Brief Pain Inventory (BPI). [Subjects and Methods] A cross-sectional study was conducted. Participants comprised 30 women, aged 30–80 years, who had received treatment for breast cancer (surgery and complementary treatment) at least 12 months prior to the study and had reported chronic pain related to the treatment procedures. [Results] The highest scores were found for " mood " (median: 5.00 points; first quartile: 1.00 points; third quartile: 7.25 points), " normal work " (median: 5.00 points; first quartile: 0.00 points; third quartile: 8.00 points), and " sleep " (median: 4.50 points, first quartile: 0.00 points, third quartile: 8.00 points). [Conclusion] Pain exerts a negative impact primarily on mood, normal work, and sleep among breast cancer survivors.
Symptom Clusters and Quality of Life in Women with Breast Cancer Receiving Adjuvant Chemotherapy
Pacific Rim International Journal of Nursing Research, 2013
This prospective longitudinal study explored symptom clusters and influences on quality of life among women with stage I-IIIA breast cancer who received treatment with chemotherapy. A sample of 112 women receiving adjuvant chemotherapy for breast cancer at a university hospital in Bangkok were recruited to this study using convenience sampling. Data were collected three times: before chemotherapy (Time 1); before receiving the second cycle of chemotherapy (Time 2), and 1-month after completion of chemotherapy (Time 3). Instruments used were a Demographic and Medical Record Form; the Modified Memorial Symptom Assessment Scale; and the Functional Assessment of Cancer Therapy-Breast. Factor analysis and multiple regression were used to identify symptom clusters and their influences on quality of life. The results revealed that the participants with breast cancer experienced multiple symptoms concurrently. There were five symptom clusters existing at each time point: menopausal, psychologically-related self-image, and gastrointestinal-related fatigue symptom clusters tended to be stable across all three stages of data collection. "I don't look like myself", worrying, and feeling drowsy were found to be the strongest predictors of quality of life across all data collection phases. Issues regarding instability of symptoms within a cluster across phases were discussed. Knowledge obtained from this study can be beneficial for nurses and other health care providers to better understand and care for multiple symptom experiences in women with breast cancer. It will also help such women to plan ahead for them to manage concurrent symptoms to promote their quality of life. However, future research is recommended to clarify the stability and extent of symptoms within various symptom clusters in women receiving chemotherapy for breast cancer.
Symptom Experience and Quality of Life of Women Following Breast Cancer Treatment
Journal of Women's Health, 2007
Results: All study participants had completed primary treatment (surgery and radiation and/or chemotherapy, if applicable). Mean time from initial surgical treatment to completion of the questionnaire was 7.2 months (range 0.5-14.9 months). Mean number of symptoms reported was 6.8, with the 5 most common symptom scales being systemic therapy side effects (87.7%), fatigue (81.7%), breast symptoms (72.1%), sleep disturbance (57.1%), and arm symptoms (55.6%). Younger age and poorer health status at diagnosis were associated with worse symptoms. Fatigue had the greatest impact on QOL, with significant differences between those with high and low fatigue across 7 QOL dimensions. Sociodemographic, prior health status, clinical, and treatment/diagnostic factors explained only 9%-27% of the variance in QOL outcomes. Adding symptom experience increased the variance explained to 18%-60%.
Longitudinal Examination of Symptom Profiles Among Breast Cancer Survivors
Journal of Pain and Symptom Management, 2017
Context-Identification of cancer patients with similar symptom profiles may facilitate targeted symptom management. Objectives-To identify subgroups of breast cancer survivors based on differential experience of symptoms, examine change in subgroup membership over time, and identify relevant characteristics and quality of life (QOL) among subgroups. Methods-Secondary analyses of data from 653 breast cancer survivors recruited within 8 months of diagnosis who completed questionnaires at five timepoints. Hidden Markov modeling was used to: 1) formulate symptom profiles based on prevalence and severity of eight symptoms commonly associated with breast cancer, and 2) estimate probabilities of changing subgroup membership over 18 months of follow-up. Ordinal repeated measures were used to: 3) identify patient characteristics related to subgroup membership, and 4) evaluate the relationship between symptom subgroup and QOL. Results-A seven-subgroup model provided the best fit: 1) low symptom burden, 2) mild fatigue, 3) mild fatigue and mild pain, 4) moderate fatigue and moderate pain, 5) moderate fatigue and moderate psychological, 6) moderate fatigue, mild pain, mild psychological; and 7) high symptom burden. Seventy percent of survivors remained in the same subgroup over time. In multivariable analyses, chemotherapy and greater illness intrusiveness were significantly related to greater symptom burden, while not being married or partnered, no difficulty paying for basics, and greater social support were protective. Higher symptom burden was associated with lower QOL. Survivors who reported psychological symptoms had significantly lower QOL than did survivors with pain symptoms. Conclusion-Cancer survivors can be differentiated by their symptom profiles.
Pain Research and Treatment, 2012
Breast cancer is a leading cancer diagnosis among women worldwide, with more than 210,000 new cases and 40,000 deaths per year in the United States. Pain, anxiety, and depression can be significant factors during the course of breast cancer. Pain is a complex experience with sensory, affective, and cognitive dimensions. While depression and anxiety symptoms are relatively common among breast cancer patients, little is known about the relation between these psychiatric factors and distinct components of the pain experience. In the present study 60 females presenting to an NCI-designated Cancer Center with newly diagnosed breast cancer completed the Center for Epidemiological Studies 10-item Depression Scale, the State Instrument of the Spielberger State-Trait Anxiety Inventory, and the McGill Pain Questionnaire. Findings indicate that anxiety and depression are common among newly diagnosed breast cancer patients; furthermore, patients experience an appreciable amount of pain even bef...
Pain Management Nursing, 2018
Background: Pain, depression, anxiety, sleep disturbances, and constipation were reported in different symptom clusters at different stages of breast cancer. Managing symptom clusters rather than individual symptoms can improve performance status. Aim: The study examined the effect of pain symptom cluster (pain and constipation) on performance when mediated by the psychoneurological symptom cluster (depression, anxiety, and sleep disturbances) using age as a moderator. Design: A secondary analysis. Settings: Palliative care center at a tertiary medical center in northeast Ohio. Participants: Eighty-six women diagnosed with advanced breast cancer. Method: A quantitative cross-sectional approach. Results: Ordinal logistic regression showed that pain symptom cluster did not have a significant mediation effect on performance. Odds ratio indicated that subjects with pain symptom cluster were 63% more likely to be bedridden (odds ratio ¼ 1.63, confidence interval ¼ .69-3.84). Women who reported pain symptom cluster were 5% more likely to have psychoneurological symptom cluster (odds ratio ¼ 1.05, confidence interval ¼ .400-2.774). Stratified analysis of age showed no differences in performance. Post-hoc analysis showed that the components of pain symptom cluster had a significant effect on psychoneurological symptom cluster (odds ratio: 3 [1.18-7.62]). Conclusions: Pain,
Interventions to Alleviate Symptoms Related to Breast Cancer Treatments and Areas of Needed Research
Journal of Cancer Science & Therapy, 2011
Treatments for breast cancer produce a host of side effects, which can become debilitating. Some cancer treatment-related side effects occur in up to 90% of patients during treatment and can persist for months or years after treatment has ended. As the number of breast cancer survivors steadily increases, the need for cancer control intervention research to alleviate side effects also grows. This review provides a general overview of recent clinical research studies of selected topics in the areas of symptom management for breast cancer with a focus on cognitive difficulties, fatigue, cardiotoxicity, bone loss, insomnia, and cancer pain. We review both pharmacological and behavioral intervention clinical research studies, conducted with breast cancer patients and survivors. Additionally, clinical perspectives on symptom management and recommendations for areas of needed research are provided.