A Longitudinal Study of PROMIS Pediatric Symptom Clusters in Children Undergoing Chemotherapy

Wang, Jichuan; Jacobs, Shana; DeWalt, Darren A.; Stern, Emily; Gross, Heather E.; Hinds, Pamela S.

doi:10.1016/j.jpainsymman.2017.08.021

Cited by 42 publications

(58 citation statements)

References 29 publications

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“…Additionally, membership in the two profiles were both relatively stable during chemotherapy cycles. This result has not been reported in patients with lung cancer, but was consistent with the previous report that used LTA to examine the changes in profile status among children patients, which revealed that subgroup membership remains relatively stable from the start to the mid-way cycle of chemotherapy ( 18 ).…”

Section: Discussionsupporting

confidence: 92%

“…This classification based on symptom scores is consistent with symptom control practice guidelines ( 30 , 31 ). Similar grouping results were found in children undergoing chemotherapy, which were defined as “less severe symptoms” and “severe symptoms” ( 18 ). A previous LTA study ( 17 ) identified three latent classes (low, moderate, high) using symptom occurrence in oncology (including lung cancer) outpatients, which differs from our findings.…”

Section: Discussionsupporting

confidence: 73%

“…A few cross-sectional studies ( 13 – 15 ) classified patients into subgroups using LCA, but a limited number of studies used longitudinal data. Four studies explored subgroups of patients prior and after chemotherapy based on symptom occurrence or severity in a heterogeneous sample ( 16 , 17 ) or specific cancer type of patients ( 18 , 19 ). Different distinct subgroups, transition status, and patient characteristics were identified using LCA and LTA.…”

Section: Introductionmentioning

confidence: 99%

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Distinct Subgroups of Patients With Lung Cancer Receiving Chemotherapy: A Latent Transition Analysis

Hou

2020

Front. Oncol.

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Objectives To identify subgroups of patients with lung cancer receiving chemotherapy based on the severity dimension of symptom experience, and to examine changes in membership between these subgroups over time. Methods Patients who were scheduled to receive chemotherapy completed the Chinese version of the MD Anderson Symptom Inventory and the revised lung cancer module with a total of 19 symptom items. Data were collected at three time points: two weeks before chemotherapy (T1), after chemotherapy cycle 1 (T2), and after chemotherapy cycle 3 or above (T3). The latent profile analysis and latent transition analysis were used to identify underlying subgroups and describe changes in subgroup membership over time. Results From the total sample ( N = 195), 160 patients completed the symptom assessment at T1, T2, and T3. Two distinct latent symptom profiles of patients could be identified at T1, T2, and T3, which were classified as “Mild” and “Moderate-Severe” profiles. From T1 to T2 and T3, members in the Mild profile were more likely to move to the Moderate-Severe profile. Chemotherapy protocols, prior surgery treatment, and level of education can predict the transitions. Conclusion Results provide a better understanding of the patient’s different symptom experiences and characteristics. These could help clinicians to anticipate symptom patterns and develop interventions in lung cancer patients who were scheduled to receive chemotherapy for the first time.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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Distinct Subgroups of Patients With Lung Cancer Receiving Chemotherapy: A Latent Transition Analysis

Hou

2020

Front. Oncol.

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“…Due to data quality, statistical confirmation of heterogeneous pain trajectories could not be performed using pain diary data so evidence from literature will be used to support this potential explanation. A longitudinal study of children with cancer provided evidence of two heterogeneous symptom trajectories which included pain: less severe and more severe (Wang et al., 2017). Another study in children with cancer found evidence of four symptom and function profiles and related this to children having another medical condition (Buckner et al., 2014).…”

Section: Discussionmentioning

confidence: 99%

Manifestation and parental assessment of children’s cancer pain at home: An exploratory mixed‐methods study

Parker

Wiseman

Twycross

et al. 2020

Journal of Clinical Nursing

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Aims and objectives: To describe pain manifestation in children with cancer at home and understand how parents assess this pain. Background: Pain is experienced by children with cancer throughout their cancer journey. Short-term, and into survivorship, pain has negative physical and psychological consequences. Changes in treatment location mean children with cancer spend more time at home. Little is known about pain experienced by children at home or how parents assess this pain. Design: A mixed-methods convergent parallel study was reported using STROBE. Method: Parents of children with cancer on active treatment were recruited from one tertiary cancer centre. Parental attitudes towards pain expression were assessed using surveys. Parents recorded their child's pain manifestation in pain diaries kept for one month. Interviews captured a deeper understanding of pain manifestation and how parents assess this pain at home. Integration occurred after each data collection method was analysed separately. Results: Predominantly children were not in pain at home. However, most children experienced at least one episode of problematic pain over the pain diary period. Surveys showed parents held misconceptions regarding children's pain expression. Interviews diverge from surveys and suggest parents used a range of information sources to assess pain. Conclusion: Children with cancer may differ from one another in the manifestation of pain at home resulting in multiple pain trajectories. Parents of children with cancer are able to adequately assess their child's pain using information from multiple sources. Relevance to clinical practice: • It is not currently possible to predict which children will experience problematic pain at home, so all parents require pain management education prior to discharge. • Teaching parents to use bundled approaches to pain assessment may accelerate their learning. • Healthcare professionals may benefit from using multiple information sources to assess pain.

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“…Children with long-term diseases such as cancer want to be have greater involvement in their own health care [ 18 - 21 ].They want to receive more information about emerging symptoms, treatment, and prognosis [ 22 ] and have the possibility to decide whether and to what extent they want to participate in decision-making processes regarding their own health care [ 18 , 23 ]. It is, however, difficult for children to explain how their long-term disease makes them feel [ 24 ] and to accept and manage the consequences and lifestyle related to their long-term disease [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study

Gilljam¹,

Nygren²,

Svedberg³

et al. 2020

J Med Internet Res

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Background For children 6-12 years old, there is a shortage of electronic Health (eHealth) services that promote their participation in health care. Therefore, a digital communication tool, called Sisom, was developed to give children a voice in their health care. Children with long-term diseases want to be more involved in their health care and have the right to receive information, be listened to, express their opinions, and participate in decision making in health care. However, the outcomes of using Sisom in practice at pediatric oncology clinics have not been investigated. Objective The aim of this study was to investigate children’s participation during appointments with pediatricians at pediatric oncology clinics, with or without the use of the eHealth service Sisom. Methods A quasiexperimental design with mixed methods was used. We analyzed 27 filmed appointments with pediatricians for 14 children (8 girls and 6 boys) aged 6-12 years (mean 8.3 years) with a cancer diagnosis. The intervention group consisted of children who used Sisom prior to their appointments with pediatricians at a pediatric oncology clinic, and the control group consisted of children who had appointments with pediatricians at 4 pediatric oncology clinics. Data from observations from the videos were quantitatively and qualitatively analyzed. The quantitative analysis included manual calculations of how many times the pediatricians spoke directly to the children, the proportion of the appointment time that the children were talking, and levels of participation by the children. For the qualitative analysis, we used directed content analysis to analyze the children’s levels of participation guided by a framework based on Shier’s model of participation. Results Pediatricians directed a greater proportion of their discussion toward the child in the intervention group (731 occasions) than in the control group (624 occasions), but the proportion of the appointment time the children talked was almost the same for both the intervention and control groups (mean 17.0 minutes vs 17.6 minutes). The levels of participation corresponded to the first three levels of Shier’s participation model: children were listened to, children were supported to express their views, and children’s views were taken into account. The results showed an increased level of participation by the children in the intervention group. Several codes that were found did not fit into any of the existing categories, and a new category was thus formed: children received information. Conclusions This study shows that the eHealth service Sisom can increase children’s participation during appointments with health care professionals. Further studies employing a randomized control design focusing on the effects of eHealth services on children’s health outcomes, perceived participation, and cost-effectiveness could make a significant contribution to guiding the implementation of eHealth services in pediatric care.

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A Longitudinal Study of PROMIS Pediatric Symptom Clusters in Children Undergoing Chemotherapy

Cited by 42 publications

References 29 publications

Distinct Subgroups of Patients With Lung Cancer Receiving Chemotherapy: A Latent Transition Analysis

Distinct Subgroups of Patients With Lung Cancer Receiving Chemotherapy: A Latent Transition Analysis

Manifestation and parental assessment of children’s cancer pain at home: An exploratory mixed‐methods study

Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study

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