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- Title
HOW DO PHYSICAL AND PSYCHOLOGICAL SYMPTOMS RELATE TO EACH OTHER IN PATIENTS WITH DIFFERENT CANCER DIAGNOSES?
- Authors
Hoffman, Amy; Given, Barbara; Given, Charles; von Eye, Alexander; Gift, Audrey
- Abstract
There is little research that examines the multiple symptoms experience and their interrelationships comparing persons with different cancer diagnoses. As a result, many persons with cancer may be inadequately treated for their symptoms. Persons recently diagnosed with lung cancer face serious concurrent physical and psychological symptoms that are likely to be interrelated and increase the overall level of symptom severity experienced. Understanding the differences between the symptom experience in persons with lung cancer relative to persons with non-lung cancer and the relationship between physical and psychological symptoms will provide insight for targeted symptom management interventions. This study examines differences in the severity levels and interrelationships of physical (pain, fatigue, and insomnia) and psychological (anxiety and depression) symptoms in persons with lung cancer relative to those with other cancer diagnoses. The Theory of Unpleasant Symptoms (TOUS) was used to guide this study. The TOUS conceptualizes symptoms as occurring together and identifies patient characteristics that influence symptoms. Secondary data analysis from baseline observation of a randomized clinical intervention trial was performed on 83 persons with lung cancer and 159 persons with non-lung cancer at the time of diagnosis. Path analysis using LISREL version 8.72 was used to examine differences in symptom interrelationships between persons with lung cancer and those with other cancers. A parsimonious model that distinguished between persons with lung cancer and those with sites of cancer other than lung (Satorra-Bentler Chi-Square 1.68; p = 0.79; DF = 4; RMSEA = 0.00; CFI = 1.00) revealed that at intake into the trial patients with lung can- cer reported lower severity of insomnia; however, in the presence of pain, lung cancer patients report greater fatigue and insomnia. Similarly, in the presence of anxiety, lung cancer patients reported higher levels of depression. Next, in the presence of pain, fatigue, and insomnia, lung cancer patients reported greater anxiety. Finally, lung cancer patients reporting fatigue and insomnia had higher levels of depression. Therefore, by knowing cancer diagnoses, oncology nurses can identify those interdependent symptom relationships, and better target dose-related nursing interventions to achieve optimal symptom management. Funding Sources: Given, B. A. & Given, C. W. (1997-2002). Family Home Care for Cancer: A Community-based Model, grant R01 NR/CA01915, funded by the National Institute for Nursing Research and the National Cancer Institute. In Collaboration with Walther Cancer Institute.
- Subjects
CANCER diagnosis; SYMPTOMS; LUNG cancer; CANCER patients; PSYCHOLOGICAL manifestations of general diseases
- Publication
Oncology Nursing Forum, 2007, Vol 34, Issue 1, p184
- ISSN
0190-535X
- Publication type
Article