Symptom clusters in head and neck cancer patients with endotracheal tube: Which symptom clusters are independently associated with health-related quality of life?

Li, Yuanyuan; Li, Xiaoshuang; Mao, Chenchen; Lv, Gaorong; Xie, Zihui; Jiang, Hua; Ping, Li

doi:10.1016/j.ejon.2020.101819

Cited by 15 publications

(11 citation statements)

References 38 publications

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“…Authors of a previous study have shown that in breast cancer patients, the higher group within the physical-gastrointestinal symptom cluster had a poor QoL in all domains than the lower group, while in the psychological-general symptom cluster, the higher group had a poor QoL in all domains except sexual functioning, which partially supported our findings that greater symptom distress resulted in a worse QoL (18). Nevertheless, Li et al's research on head and neck cancer patients with endotracheal tubes revealed that there was no significant difference in the scores of QoL between the high and low severity groups of the digestive symptom cluster (47). These contradictory results may be related to disease characteristics, treatment modalities, and the different study periods investigated (49,50).…”

Section: Discussionsupporting

confidence: 85%

“…In addition to the latent impact of the research population and instruments, the main reason for the inconsistencies is that symptoms could change with the progress of treatment undergoing CCRT (47). Thus, health care workers should put particular emphasis on the identification of symptom clusters, especially problems with fatigue, to guide prompt and effective symptom management interventions.…”

Section: Discussionmentioning

confidence: 99%

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Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions

et al. 2022

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ObjectivesAlthough studies shows that symptom clusters and illness perceptions are negatively associated with quality of life (QoL), it is unclear how these variables of cervical cancer patients who receive concurrent chemoradiotherapy (CCRT) relate to each other. This study aimed to identify the symptom clusters in cervical cancer patients who receive CCRT and evaluate the mediating effect of illness perceptions on the relationship between symptom clusters and QoL.MethodsA cross-sectional survey was conducted on 286 cervical cancer patients receiving CCRT from October 2019 to October 2020. M.D. Anderson Symptom Inventory, Brief Illness Perception Questionnaire, and Functional Assessment Cancer Therapy-Cervix were applied to investigate the symptom clusters, illness perceptions and QoL of the participants, respectively. Exploratory factor analysis was conducted to identify symptom clusters. The relationships among symptom clusters, illness perceptions, and QoL were analyzed with the structural equation modeling.ResultsA total of four symptom clusters were identified, including psychological status symptom cluster, therapy side-effect symptom cluster, sickness symptom cluster, and gastrointestinal symptom cluster (χ2 = 1,552.282, Df = 78, P < 0.001). Symptom clusters, illness perceptions, and QoL were significantly correlated. Symptom clusters had significant direct (β = −0.38, P < 0.001) and indirect effects (β = −0.21, P < 0.001) on QoL.ConclusionIllness perceptions played a significant mediating role between symptom clusters and QoL in cervical cancer patients receiving CCRT. Strategies like prompting effective symptom management for the purposes of alleviating illness perceptions may contribute to improving their QoL.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions

et al. 2022

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“…51 As Alice et al found, head and neck cancer patients had more disturbance because of constipation. 52 Gastric and pancreatic cancer patients had more nausea and vomiting, who experienced more digestive symptom clusters 53 due to impaired gastric emptying and delayed gastrointestinal transit like bowel obstruction, gastric bleed, enteritis, and constipation, which were most common underlying causes of nausea and vomiting. 6 Fatigue-related symptom cluster and malnutrition related symptom cluster are common for gastric cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Features and Factors Associated With Do-Not-Resuscitate Consent in Advanced Cancer Patients Admitted to Palliative Care Ward

Fan

Yang

et al. 2022

Am J Hosp Palliat Care

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This study aimed to conduct a retrospective cross-sectional study to investigate the prevalence of symptoms and symptom clusters on sociodemographic and disease characteristics, as well as factors associated with Do-Not-Resuscitate (DNR) consent. Advanced cancer patients were enrolled between 2018 and 2020 with available data. Demographic and clinical data were obtained for analysis from Hospital Information System (HIS) in China. Symptom clusters were extracted by hierarchical cluster analysis. Chi-square test and multiple logistic regression were conducted to investigate the prevalence characteristics of symptoms and influencing factors of DNR consent, respectively. 798 advanced cancer patients were enrolled. The most prevalent symptoms were pain (93%), anorexia (36.5%), and sleep disorders (34.2%). High heart rate was associated with poor performance status and more symptoms. Three clusters were extracted: fatigue-related, respiratory-circulatory system, and digestive system symptom clusters. The incidence of symptoms was statistically significant in age, gender, education level, residence, BMI, performance status, distress score, ADL, and primary pain level. The DNR signature rate was 15.5%. Female, distant metastasis, in-ward rescue, and appearance of dyspnea were independent influencing factors of DNR signature. Chinese hospitalized cancer patients had more symptoms burden that were influenced by various demographic characteristics, especially pain and fatigue-related symptoms. Concerning the trajectory of vital signs is important among advanced cancer patients. The DNR signature rate was lower and our finding indicating an urgency to accurately assess the prognosis and give more palliative care education to enhance DNR rates and early signing in Chinese context.

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“…3,4 These multiple co-occurring symptoms can negatively impact patients' functional status, quality of life (QOL), and survival rates. 5,6 In a mixed methods study, patients with HNC experienced varying levels of PNS that affected their functional well-being and QOL. 7 In another national cohort study of 1589 patients with HNC, 6 patients with one symptom had a median survival of 5.3 years compared to only 1.1 years for patients with three symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Psychoneurological symptoms (PNS) that include depression, fatigue, sleep disturbance, pain, and cognitive dysfunction are among the most common and distressing symptoms reported by patients with HNC undergoing IMRT 3,4 . These multiple co‐occurring symptoms can negatively impact patients' functional status, quality of life (QOL), and survival rates 5,6 . In a mixed methods study, patients with HNC experienced varying levels of PNS that affected their functional well‐being and QOL 7 .…”

Section: Introductionmentioning

confidence: 99%

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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Symptom clusters in head and neck cancer patients with endotracheal tube: Which symptom clusters are independently associated with health-related quality of life?

Cited by 15 publications

References 38 publications

Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions

Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions

Symptomatic Features and Factors Associated With Do-Not-Resuscitate Consent in Advanced Cancer Patients Admitted to Palliative Care Ward

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

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