Advancing the science of symptom management

Abstract

The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home-care settings because few models of symptom management have been tested empirically. To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly-based symptom management model allows the integration of science from other fields.

Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

“…[6][7][8] Patients with lung cancer often experience symptoms concurrently and they usually have overlapping and interactive effects. 9,10 A symptom cluster is defined as three or more concurrent symptoms that are moderately correlated with each other. 11 Providing an intervention aimed at treating a symptom cluster as a whole could lead to greater effectiveness and efficiency, which potentially maximizes the use of clinicians' as well as patients' efforts.…”

Symptom-reducing actions: a concept analysis in the context of chronic obstructive pulmonary disease

“…A self-management intervention includes several components: stimulation of symptom monitoring; education in problem-solving skills regarding acute exacerbations or symptoms; resource utilization; enhancement of medication adherence; physical activity; dietary intake; and smoking cessation (Jonkman, Schuurmans, Groenwold, Hoes, & Trappenburg, 2016). Situational factors such as caregiver characteristics and cultural background are important in reducing symptoms (Dodd et al, 2001; Hutchinson & Wilson, 1998). Assessment of symptoms should include the patient’s own assessment, clinical parameters, and observation by others (Teel, Meek, McNamara, & Watson, 1997).…”

“…The goal is to avert or delay a negative outcome through biomedical, professional, and self-care strategies. This is a dynamic process which involves changing strategies over time or in response to a patient’s acceptance (or lack of acceptance) of the strategy (Dodd et al, 2001; Larson & UCSF, 1994). A more generic intervention that takes the approach of providing patients with education, self-care skills, and support is needed.…”

“…A more generic intervention that takes the approach of providing patients with education, self-care skills, and support is needed. It is important to include family members (Dodd et al, 2001). The patient and the nurse require varying amounts of time to allow for the revelation, initial understanding, clarification, and interpretation of the symptom experience (Haworth & Dluhy, 2001).…”

“…Several COPD-specific instruments are available to measure the effectiveness of symptom-reducing actions.The evidence for improvement in exercise endurance, dyspnoea, functional capacity, and quality of life is stronger for rehabilitation than for almost any other therapy in COPD, and documentation of its favourable effect on health care utilization is increasing. The success of pulmonary rehabilitation stems from its favourable influence on systemic effects and comorbidities associated with chronic lung disease.Dodd et al, 2001 J Adv Nurs Concept model of symptom managementThe goal of symptom management is to avert or delay a negative outcome through biomedical, professional, and self-care strategies. Management begins with assessment of the symptom experience from the individual’s perspective.Assessment is followed by identifying the focus for interven tion strategies.The symptom management model continues to evolve as a framework for understanding symptoms, designing, and testing management strategies and for evaluating outcomes.Erdley, 2005 Comput Inform Nurs Concept development of nursing informationInformation is the function of the communication process between interacting persons, whether verbal or written.…”