Symptom Clusters in Patients with Cancer with Metastatic Bone Pain

Hadi, Stephanie; Fan, Grace; Hird, Amanda; Kirou-Mauro, Andrea; Filipczak, Linda A.; Chow, Edward

doi:10.1089/jpm.2007.0145

Cited by 42 publications

(41 citation statements)

References 26 publications

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“…However, only worst pain was included in our study's analysis. Consequently, worst pain compounded the activity-related interference found in our initial symptom cluster research in cancer patients with metastatic bone pain 11 . The findings in the present validation study differ slightly from our initial symptom cluster research 11 .…”

Section: Discussionmentioning

confidence: 79%

“…Consequently, worst pain compounded the activity-related interference found in our initial symptom cluster research in cancer patients with metastatic bone pain 11 . The findings in the present validation study differ slightly from our initial symptom cluster research 11 . We extracted 2 symptom clusters before RT start, calling cluster 1 "activity-related interference" and cluster 2 "psychology-related interference."…”

Section: Discussionmentioning

confidence: 79%

“…The primary objective of the present study was to validate the findings from our previous study 11 by comparing the extracted symptom clusters at baseline and at 4, 8, and 12 weeks post RT.…”

mentioning

confidence: 83%

“…The BPI is the most frequently used multiple-item measure of pain in cancer research 6 , and it is measured on the sensory and affective dimensions. The sensory component of 11 …”

Section: Introductionmentioning

confidence: 99%

“…From May 2003 to January 2007, we conducted a previous study at the Odette Cancer Centre and, using the BPI, extracted 2 symptom clusters in patients receiving palliative radiation therapy (RT) for symptomatic bone pain 11 . The 348 individuals who agreed to participate in the study completed the BPI before RT (baseline) and at weeks 4, 8, and 12 post RT 11 .…”

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confidence: 99%

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Validation of Symptom Clusters in Patients with Metastatic Bone Pain

et al. 2008

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PurposeSymptom clusters (SCs) are a dynamic construct. They consist of at least 2 or 3 interrelated symptoms that may be a significant predictor of patient morbidity. In a previous study, we identified 2 SCs in patients with bone metastases:• An activity-related interference cluster • A psychology-related interference cluster These SCs may be clinically important in the pain and symptom management of patients with metastatic bone pain. It is therefore important to validate the reported SCs to determine if they hold true across similar patient populations. Patients and MethodsFrom February to September 2007, our study accrued 52 patients with bone metastases [29 men (56%), 23 women (44%); median age: 68.5 years (range: 39-87 years)] who were referred for palliative radiotherapy (RT). Prostate (31%), breast (29%), and lung (19%) were the most common primary cancer sites. Treatment arms ranged from single to multiple fractions, with most patients receiving a single 8-Gy fraction (77%) or 20 Gy in 5 fractions (21%). The most prevalent sites for RT were spine (42%), hips (17%), and pelvis (14%). Worst pain at the site of RT and functional interference scores were assessed using the Brief Pain Inventory (BPI), a multidimensional pain instrument that uses 11-point numeric rating scales. Patients provided their symptom severity scores on the BPI at baseline and at 4, 8, and 12 weeks post RT. At all time points, a principal component analysis with varimax rotation was performed on 8 items (worst pain and 7 functional interference items) to determine relationships between symptoms before and after RT for bone pain. ResultsTwo SCs were identified. Cluster 1 included worst pain and interference with general activity, normal work, and walking ability; cluster 2 consisted of interference with mood, sleep, enjoyment of life, and relations with others. Our statistical analysis produced varied results for the 2 clusters found in our previous investigation. These differences may be an indicator for the instability of SCs or may be a result of the fewer number of patients accrued in the present validation study. ConclusionsThe SCs in our two studies were not identical for patients receiving palliative RT for symptomatic bone metastases. Another SC validation study should be conducted with a larger sample before a conclusion is drawn about the existence of an unstable phenomenon in SC research. KEY WORDSBone metastases, metastatic bone pain, palliative radiotherapy, symptom cluster, symptom cluster instability

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 83%

“…The BPI is the most frequently used multiple-item measure of pain in cancer research 6 , and it is measured on the sensory and affective dimensions. The sensory component of 11 …”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Validation of Symptom Clusters in Patients with Metastatic Bone Pain

et al. 2008

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Somatic Symptoms in Patients With Cancer Experiencing Pain or Depression

Kroenke¹,

Zhong²,

Theobald³

et al. 2010

Arch Intern Med

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Background The adverse impact of high somatic symptom burden is well established for primary care and other noncancer populations with chronic medical disorders. This study examines the impact of somatic symptom burden on disability and health care use in cancer patients suffering from pain and/or depression. Methods Secondary analysis of baseline data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale. Multivariable models were conducted to determine the association of somatic symptom burden with the Sheehan Disability Scale (SDS) score, the number of self-reported disability days in the past 3 months, and health care use. Models were adjusted for sociodemographic characteristics, medical comorbidity, and depression and pain severity. Results Somatic symptoms were highly prevalent, with 15 of the 22 symptoms reported by more than 50% of patients. Somatic symptom burden was similar across different types and phases of cancer. The mean SDS (scored 0 to 10) was 5.4 and the mean number of self-reported disability days in the past 4 weeks was 16.9 days. In multivariable models, somatic symptom burden was associated with both SDS (P < .001) and the likelihood of ≥ 14 disability days in the past 4 weeks (OR=1.51; 95% CI, 1.19–1.92) but was not with increased health care use. Conclusions Somatic symptom burden is high in cancer patients with pain and/or depression. Given the strong association with disability and the high prevalence of many types of symptoms, recognizing and managing somatic symptoms may be important in improving quality of life and functional status regardless of type or phase of cancer.

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Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained?

et al. 2014

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Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality.

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Symptom Clusters in Patients with Cancer with Metastatic Bone Pain

Cited by 42 publications

References 26 publications

Validation of Symptom Clusters in Patients with Metastatic Bone Pain

Validation of Symptom Clusters in Patients with Metastatic Bone Pain

Somatic Symptoms in Patients With Cancer Experiencing Pain or Depression

Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained?

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