TY - JOUR
T1 - Symptom Cluster Experience Profiles in Adult Survivors of Childhood Cancers
AU - Finnegan, Lorna
AU - Campbell, Richard T.
AU - Ferrans, Carol Estwing
AU - Wilbur, Jo Ellen
AU - Wilkie, Diana J.
AU - Shaver, Joan
N1 - Funding Information:
This project was supported by: 1) a University of Illinois College of Nursing Internal Research Support Grant; 2) Grant # P30 NR009014 Center for Reducing Risks in Vulnerable Populations from the National Institute of Nursing Research; and 3) an Oncology Nursing Society Foundation Small Research Grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.
PY - 2009/8
Y1 - 2009/8
N2 - Although aggressive medical treatment protocols have led to 80% five-year survival rates for most childhood cancer patients, many long-term survivors experience multiple troubling symptoms. Using data from 100 adult survivors of childhood cancers (ACC-survivors), we used latent variable mixture modeling to generate unique subgroups of survivors based on their experiences with a cluster of eight symptoms: lack of energy, worry, pain, difficulty sleeping, feeling irritable, feeling nervous, difficulty concentrating, and feeling sad (as measured by the Memorial Symptom Assessment Scale). We also examined factors that were likely to predict subgroup membership (chronic health conditions [CHCs], health-promoting lifestyle, and demographic variables) and determined the extent to which satisfaction with quality of life (QoL) varied across the subgroups. The final mixture model included three subgroups of ACC-survivors: high symptoms (HS; n = 21), moderate symptoms (MS; n = 45), and low symptoms (LS; n = 34). ACC-survivors who reported at least one CHC were six times as likely to be classified in the HS subgroup as compared with the LS subgroup. Mean health-promoting lifestyle scores were lowest in the HS subgroup and highest in the LS subgroup. Differences in QoL among the subgroups were statistically significant, thus validating that the subgroups were characterized uniquely for identifying those symptoms with highest life impact. To our knowledge, we are the first to identify distinct subgroups of ACC-survivors differentiated by symptom cluster experience profiles. The findings warrant additional research to confirm the subgroup-specific symptom cluster experience profiles in larger studies of ACC-survivors.
AB - Although aggressive medical treatment protocols have led to 80% five-year survival rates for most childhood cancer patients, many long-term survivors experience multiple troubling symptoms. Using data from 100 adult survivors of childhood cancers (ACC-survivors), we used latent variable mixture modeling to generate unique subgroups of survivors based on their experiences with a cluster of eight symptoms: lack of energy, worry, pain, difficulty sleeping, feeling irritable, feeling nervous, difficulty concentrating, and feeling sad (as measured by the Memorial Symptom Assessment Scale). We also examined factors that were likely to predict subgroup membership (chronic health conditions [CHCs], health-promoting lifestyle, and demographic variables) and determined the extent to which satisfaction with quality of life (QoL) varied across the subgroups. The final mixture model included three subgroups of ACC-survivors: high symptoms (HS; n = 21), moderate symptoms (MS; n = 45), and low symptoms (LS; n = 34). ACC-survivors who reported at least one CHC were six times as likely to be classified in the HS subgroup as compared with the LS subgroup. Mean health-promoting lifestyle scores were lowest in the HS subgroup and highest in the LS subgroup. Differences in QoL among the subgroups were statistically significant, thus validating that the subgroups were characterized uniquely for identifying those symptoms with highest life impact. To our knowledge, we are the first to identify distinct subgroups of ACC-survivors differentiated by symptom cluster experience profiles. The findings warrant additional research to confirm the subgroup-specific symptom cluster experience profiles in larger studies of ACC-survivors.
KW - Cancer
KW - adult survivors of childhood cancers
KW - latent variable mixture models
KW - oncology
KW - quality of life
KW - symptom cluster
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U2 - 10.1016/j.jpainsymman.2008.09.010
DO - 10.1016/j.jpainsymman.2008.09.010
M3 - Article
C2 - 19535218
AN - SCOPUS:67651151566
SN - 0885-3924
VL - 38
SP - 258
EP - 269
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 2
ER -