Symptom Trajectories in Children Receiving Treatment for Leukemia: A Latent Class Growth Analysis With Multitrajectory Modeling

Hockenberry, Marilyn J.; Hooke, Mary C.; Rodgers, Cheryl; Taylor, Olga A.; Koerner, Kari M.; Mitby, Pauline; Moore, Ida M.; Scheurer, Michael E.; Pan, Wei

doi:10.1016/j.jpainsymman.2017.03.002

Cited by 67 publications

(74 citation statements)

References 24 publications

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“…Because the three symptom measures (fatigue, pain, and nausea) were highly correlated with each other at each time point (Hockenberry et al, 2017), they were combined as a symptom cluster. through exploratory factor analysis with maximum likelihood estimation which returned a one-factor solution with significant factor loadings from .35 to .88 and at least 54% of variance explained at each time point (Table 14).…”

Section: Data Collectionmentioning

confidence: 99%

Influence of Inflammatory and Oxidative Stress Pathways on Longitudinal Symptom Experiences in Children With Leukemia

Hockenberry

Pan

Scheurer

et al. 2019

Biological Research For Nursing

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Purpose: The purpose of this study was to explore the influence of oxidative stress (F2-isoprostanes) and inflammatory (interleukin [IL]-8) biomarkers on symptom trajectories during the first 18 months of childhood leukemia treatment. Method: A repeated-measures design was used to evaluate symptoms experienced by 218 children during treatment. A symptom cluster (fatigue, pain, and nausea) was explored over four time periods: initiation of post-induction therapy, 4 and 8 months into post-induction therapy, and the beginning of maintenance therapy (12 months postinduction). F2-isoprostanes and IL-8 were evaluated in cerebrospinal fluid (CSF) samples collected at baseline (diagnosis) and then at the four time periods. The longitudinal relationships of these biomarkers with the symptom cluster were examined using the longitudinal parallel process. Results: Pain and fatigue levels were highest during the post-induction phases of treatment and decreased slightly during maintenance therapy, while nausea scores were relatively stable. Even in the later phases of treatment, children continued to experience symptoms. CSF levels of the biomarkers increased during the post-induction phases of treatment. Early increases in the biomarkers were associated with more severe symptoms during the same period; patients who had increased biomarkers over time also experienced more severe symptoms over time. Conclusions: Findings reveal that children experienced symptoms throughout the course of leukemia treatment and support hypothesized longitudinal relationships of oxidative stress and inflammatory biomarkers with symptom severity. Activation of the biomarker pathways during treatment may explain underlying mechanisms of symptom experiences and identify which children are at risk for severe symptoms.

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Section: Data Collectionmentioning

confidence: 99%

Influence of Inflammatory and Oxidative Stress Pathways on Longitudinal Symptom Experiences in Children With Leukemia

Hockenberry

Pan

Scheurer

et al. 2019

Biological Research For Nursing

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“…The first common approach was categorizing symptoms, which is a “variable-oriented” approach that focused on symptom variables ( 6 ). Most common statistical analysis, such as principal components analysis (PCA) ( 7 ), factor analysis (FA) ( 8 ), and cluster analysis ( 9 ) were used to identify symptom clusters in patients with lung cancer. Emotional or psychological and gastrointestinal symptom clusters were commonly identified.…”

Section: Introductionmentioning

confidence: 99%

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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“…The symptoms of fatigue, sleep disturbances, pain, nausea, and depression were evaluated by child self-report or parent proxy in 236 children. 3 Latent class growth analysis was used to categorize patients into mild, moderate, and severe symptom groups who followed distinct symptom trajectories over four intensive phases of ALL therapy. 3 In an earlier study, Buckner and colleagues conducted a latent profile analysis of children with cancer analyzing both patient-reported symptoms and functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…3 Latent class growth analysis was used to categorize patients into mild, moderate, and severe symptom groups who followed distinct symptom trajectories over four intensive phases of ALL therapy. 3 In an earlier study, Buckner and colleagues conducted a latent profile analysis of children with cancer analyzing both patient-reported symptoms and functional outcomes. They noted that evaluating functional impairments in relation to symptoms is essential to understanding how cancer impacts the child’s quality of life.…”

Section: Introductionmentioning

confidence: 99%

Physical Activity, the Childhood Cancer Symptom Cluster–Leukemia, and Cognitive Function

et al. 2018

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Symptom Trajectories in Children Receiving Treatment for Leukemia: A Latent Class Growth Analysis With Multitrajectory Modeling

Abstract: This study is unique in that groups of patients with similar symptoms were identified rather than groups of symptoms. Further research using latent class growth analysis is needed.

Cited by 67 publications

References 24 publications

Influence of Inflammatory and Oxidative Stress Pathways on Longitudinal Symptom Experiences in Children With Leukemia

Influence of Inflammatory and Oxidative Stress Pathways on Longitudinal Symptom Experiences in Children With Leukemia

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

Physical Activity, the Childhood Cancer Symptom Cluster–Leukemia, and Cognitive Function

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