Distinct profiles of multiple co-occurring symptoms in patients with gastrointestinal cancers receiving chemotherapy

Lin, Yu-Fen; Bailey, Donald E.; Docherty, Sharron L.; Porter, Laura S.; Cooper, Bruce A.; Paul, Steven M.; Kober, Kord M.; Hammer, Marilyn J.; Wright, Fay; Dunn, Laura B.; Conley, Yvette P.; Levine, Jon D.; Miaskowski, Christine

doi:10.1007/s00520-020-05946-4

Cited by 12 publications

(3 citation statements)

References 49 publications

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“…Three demographic and clinical characteristics were associated with stronger symptom networks before IMRT. Although findings are inconsistent regarding gender differences in PNS among oncology patients, 45,46 in our study, women were more likely to have stronger symptom networks. In addition, higher levels of stress were associated with stronger symptom networks for patients with HNC.…”

Section: Discussioncontrasting

confidence: 70%

A network analysis of self‐reported psychoneurological symptoms in patients with head and neck cancer undergoing intensity‐modulated radiotherapy

Lin

Bruner

Paul

et al. 2022

Cancer

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Background Patients with head and neck cancer experience psychoneurological symptoms (PNS) (i.e., depression, fatigue, sleep disturbance, pain, and cognitive dysfunction) during intensity‐modulated radiotherapy (IMRT) that decrease their functional status, quality of life, and survival rates. The purpose of this study was to examine and visualize the relationships among PNS within networks over time and evaluate for demographic and clinical characteristics associated with symptom networks. Methods A total of 172 patients (mean age, 59.8 ± 9.9 years; 73.8%, male; 79.4%, White) completed symptom questionnaires four times, namely, before IMRT (T1), 1 month (T2), 3 months (T3), and 12 months (T4) post IMRT. Network analysis was used to examine the symptom‐symptom relationships among PNS. Centrality indices, including strength, closeness, and betweenness, were used to describe the degrees of symptom network interconnections. Network comparison test was used to assess the differences between two symptom networks. Results Depression was associated with the other four symptoms, and fatigue was associated with the other three symptoms across the four assessments. Based on the centrality indices, depression (rstrength = 1.3–1.4, rcloseness = 0.06–0.08, rbetweeness = 4–10) was the core symptom in all symptom networks, followed by fatigue. Female gender, higher levels of stress, and no alcohol use were associated with stronger symptom networks in network global strength before IMRT. Conclusion Network analysis provides a novel approach to gain insights into the relationships among self‐reported PNS and identify the core symptoms and associated characteristics. Clinicians may use this information to develop symptom management interventions that target core symptoms and interconnections within a network. Lay summary This study describes the symptom–symptom relationships for five common symptoms in patients with head and neck cancer receiving radiotherapy. Depression and fatigue appeared to be two core symptoms that were connected with sleep disturbance, pain, and cognitive dysfunction within a network. Several characteristics (i.e., female, higher stress, no alcohol use) were associated with stronger symptom networks.

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Section: Discussioncontrasting

confidence: 70%

A network analysis of self‐reported psychoneurological symptoms in patients with head and neck cancer undergoing intensity‐modulated radiotherapy

Lin

Bruner

Paul

et al. 2022

Cancer

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“…In our previous studies, 52,53 we found that patients with gastrointestinal cancers experienced an average of 10 to 15 multiple co-occurring symptoms. Similar to the GSDS subscale scores, levels of trait and state anxiety, depressive symptoms, cognitive dysfunction, morning and evening fatigue, and pain intensity and interference were significantly different among the 3 sleep disturbance classes of patients with gastrointestinal cancers (Table 4).…”

Section: E424mentioning

confidence: 86%

Distinct Sleep Disturbance Profiles in Patients With Gastrointestinal Cancers Receiving Chemotherapy

et al. 2021

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BackgroundPatients with gastrointestinal cancers experience moderate to high levels of sleep disturbance during chemotherapy that decreases their functional status and quality of life (QOL).ObjectiveThe objectives of this study were to identify subgroups of patients with gastrointestinal cancers with distinct sleep disturbance profiles and evaluate for differences among these subgroups in demographic, clinical, and sleep characteristics, as well as co-occurring symptoms and QOL outcomes.MethodsPatients (n = 405) completed questionnaires 6 times over 2 cycles of chemotherapy. Latent profile analysis was used to identify subgroups of patients with distinct sleep disturbance profiles.ResultsThree distinct sleep disturbance profiles (ie, low, high, very high) were identified. Compared with the low class, patients in the other 2 classes were significantly younger and less likely to be married and to exercise on a regular basis and received a higher number of previous treatments. Compared with the low class, patients in the other 2 classes reported higher levels of anxiety, depressive symptoms, morning and evening fatigue, and pain and lower levels of attentional function and QOL scores at enrollment.ConclusionsThis study is the first to use latent profile analysis to identify subgroups of patients with gastrointestinal cancers with distinct sleep disturbance profiles. Findings provide new insights on the associations between sleep disturbance and multiple co-occurring symptoms in these patients.Implications for PracticeClinicians can identify patients who are at the highest risk for sleep disturbance and recommend a variety of sleep hygiene interventions (eg, establishment of a bedtime routine), as well as initiate interventions for other co-occurring symptoms.

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“…Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths in the United States [ 1 ]. Patients with CRC receiving chemotherapy often experience severe and distressing psychoneurological symptoms (PNS) that include fatigue, depression, anxiety, sleep disturbance, pain, and cognitive dysfunction [ 2 - 5 ]. When these multiple co-occurring symptoms are undertreated, they negatively affect functional status, survival rates, and quality of life (QOL) of patients and decrease health outcomes (eg, QOL and mood) of their family caregivers (hereafter “caregivers,” defined as family members or significant others identified by the patients as their primary source of emotional and physical support) [ 6 - 8 ].…”

Section: Introductionmentioning

confidence: 99%

A Web-Based Dyadic Intervention to Manage Psychoneurological Symptoms for Patients With Colorectal Cancer and Their Caregivers: Protocol for a Mixed Methods Study

Lin¹,

Porter²,

Chee³

et al. 2023

JMIR Res Protoc

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Background Patients with colorectal cancer (CRC) receiving chemotherapy often experience psychoneurological symptoms (PNS; ie, fatigue, depression, anxiety, sleep disturbance, pain, and cognitive dysfunction) that negatively impact both patients’ and their caregivers’ health outcomes. Limited information is available on PNS management for CRC patient and caregiver dyads. Objective The purposes of this study are to (1) develop a web-based dyadic intervention for patients with CRC receiving chemotherapy and their caregivers (CRCweb) and (2) evaluate the feasibility, acceptability, and preliminary effects of CRCweb among patient-caregiver dyads in a cancer clinic. Methods A mixed methods approach will be used. Semistructured interviews among 8 dyads will be conducted to develop CRCweb. A single-group pre- and posttest clinical trial will be used to examine the feasibility, acceptability, and preliminary effects of the intervention (CRCweb) among 20 dyads. Study assessments will be conducted before (T1) and after intervention (T2). Content analysis will be performed for semistructured interviews. Descriptive statistics will be calculated separately for patients and caregivers, and pre-post paired t tests will be used to evaluate treatment effects. Results This study was funded in November 2022. As of April 2023, we have obtained institutional review board approval and completed clinical trial registration and are currently recruiting patient-caregiver dyads in a cancer clinic. The study is expected to be completed in October 2024. Conclusions Developing a web-based dyadic intervention holds great promise to reduce the PNS burden in patients with CRC receiving chemotherapy and their caregivers. The findings from this study will advance intervention development and implementation of symptom management and palliative care for patients with cancer and their caregivers. Trial Registration ClinicalTrials.gov NCT05663203; https://clinicaltrials.gov/ct2/show/NCT05663203 International Registered Report Identifier (IRRID) PRR1-10.2196/48499

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Distinct profiles of multiple co-occurring symptoms in patients with gastrointestinal cancers receiving chemotherapy

Cited by 12 publications

References 49 publications

A network analysis of self‐reported psychoneurological symptoms in patients with head and neck cancer undergoing intensity‐modulated radiotherapy

A network analysis of self‐reported psychoneurological symptoms in patients with head and neck cancer undergoing intensity‐modulated radiotherapy

Distinct Sleep Disturbance Profiles in Patients With Gastrointestinal Cancers Receiving Chemotherapy

A Web-Based Dyadic Intervention to Manage Psychoneurological Symptoms for Patients With Colorectal Cancer and Their Caregivers: Protocol for a Mixed Methods Study

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