Biomedical subjects

Natalya Verbitsky

Publications and source records attributed to Natalya Verbitsky.

4 recordsLinked to original sources

PubMed2006

Symptom experience in the last year of life among individuals with cancer.

Individuals with cancer often experience many symptoms that impair their quality of life at the end of life. This study examines symptom experience at end of life among individuals with cancer, and determines if symptom experience changes with proximity to death, or differs by depressive symptomatology, sex, site of cancer, or age. A secondary analysis of data from three prospective, descriptive, longitudinal studies (n=174) was performed, using a three-level hierarchical linear model. Fatigue, weakness, pain, shortness of breath, and cough were the five most prevalent symptoms in the last year of life. The symptom experience in the last year of life was significantly associated with site of cancer, depressive symptomatology, dependencies in activities of daily living, and independent activities of daily living at the start of the study. These findings shed light on the symptom experience in the last year of life for individuals with cancer. With greater understanding of the symptom experience, intervention strategies can be targeted to achieve the desired outcome of increased quality of life at the end of life.

Activities of Daily Living↗

PubMed2005

Reducing symptom limitations: a cognitive behavioral intervention randomized trial.

Until now, little research has been conducted examining the reactive dimension, or the degree to which a symptom limits an individual's life, in a multiplicity of symptoms. This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations. The purpose was threefold: to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer, who are receiving chemotherapy; to determine, after adjusting for covariates, how symptom limitations change over time; and to describe which symptoms are most limiting. This randomized control trial was conducted in two comprehensive and four community cancer centers. Two hundred thirty-seven individuals, aged 31-87, newly diagnosed with solid tumor cancers, participated. The experimental group (118 individuals) received a 10-contact, 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms. The control group (119 individuals) received conventional care. Interviews occurred at baseline, 10, 20, and 32 weeks. Data analysis used a two-level hierarchical linear model. Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group. At the onset of the study, younger patients reported more symptom limitations than their older counterparts; however, this was reversed by the end of the study. The cognitive behavioral intervention was key to decreasing symptom limitations. Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations.

Adult↗

PubMedDate not supplied

An analytic strategy for modeling multiple-item responses: a breast cancer symptom example.

BACKGROUND: Item Response Theory (IRT) is increasingly applied in health research to combine information from multiple-item responses. IRT posits that a person's susceptibility to a symptom is driven by the interaction of the characteristics of the symptom and person. This article describes the statistical background of incorporating IRT into a multilevel framework and extends this approach to longitudinal health outcomes, where the self-report method is used to construct a multi-item scale. METHODS: A secondary analysis of data from 2 descriptive longitudinal studies is performed. The data include 21 symptoms reported across time by 350 women with breast cancer. A 3-level hierarchical linear model (HLM) was used for the analysis. Level 1 models the item responses, consisting of symptom presence or absence. Level 2 models the trajectory of each individual, representing change over time of the IRT-created latent variable symptom experience. Level 3 explains that trajectory using person-specific characteristics such as age and location of care. The purpose of the analysis is to examine if older and younger women with breast cancer differ in their symptom experience trajectory after controlling for location of care. RESULTS: Fatigue and pain were the most prevalent symptoms. The symptom experience of women with breast cancer was found to improve over time. Neither age nor location of care was significantly associated with the symptom experience trajectory. DISCUSSION: Embedding IRT into an HLM framework produces several benefits. The example provided demonstrates benefits through the creation of a latent symptom experience variable that can be used either as an outcome or as a covariate in another model, examining the latent symptom experience trajectory and its relationship with covariates at the individual level, and managing symptom nonresponse.

Adult↗

PubMedDate not supplied

Physical functioning: effect of behavioral intervention for symptoms among individuals with cancer.

BACKGROUND: Individuals with cancer receiving chemotherapy suffer deterioration in physical functioning due to symptoms arising from the cancer disease process and its treatment. OBJECTIVES: To determine if age, chronic health conditions (comorbidity), stage of cancer, depressive symptomatology, symptom limitations, sex, and site of cancer moderate the effects of cognitive behavioral intervention on physical function and to determine if symptom limitations mediate the effect of the intervention on physical functioning. METHODS: Two hundred thirty-seven individuals with solid tumor cancer (118 experimental and 119 control group) participated in this 10-contact, 18-week randomized control trial. Cognitive behavioral theory guided the nurse-delivered problem-solving experimental intervention. The control group received conventional care. Interviews occurred at baseline and 10, 20, and 32 weeks. RESULTS: Women with breast cancer had significantly better physical functioning than women with lung cancer. Chronic health conditions, symptom limitation, and depressive symptomatology at baseline were found to moderate the effect of intervention on physical function. Symptom limitation, however, was not found to mediate the effect of intervention on physical functioning. DISCUSSION: The intervention was shown to affect physical function trajectories differently for individuals with different personal and health characteristics. Because poor physical functioning is strongly associated with mortality and poor quality of life, this information may be used by health professionals to target interventions to those who might be most responsive.

Activities of Daily Living↗