PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Symptoms”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

Symptom, symptom experiences, and symptom distress encountered by women with breast cancer undergoing current treatment modalities.

Adjuvant chemotherapy protocols used to treat women with breast cancer have evolved over the last decade and have dramatically altered the symptoms and symptom experiences of these women. The purpose of this study was to identify symptoms, symptom experiences, and resulting symptom distress encountered by women with breast cancer undergoing surgery and receiving current chemotherapy protocols. Convenience sampling was used to recruit 20 women for this study. Women were asked to tell their story and transcripts were analyzed using Colaizzi's procedural steps. Six themes emerged. The most important theme was that symptom experiences and symptom distress, similar among all 20 women, were congruent with the type of treatment. After surgery, women complained of numbness, pulling, and body image changes; while receiving Adriamycin and Cyclophosphamide, symptoms of intense nausea and hair loss caused distress; while receiving Paclitaxel, symptoms of intense bone pain and peripheral neuropathy caused distress. This study provides oncology nurses with a clear description of the symptoms, symptom experiences, and symptom distress women with breast cancer encounter during present-day treatment protocols. Knowing the symptoms and symptom experiences, as well as when they occur during treatment, provides oncology nurses with an opportunity to share with women about to start treatment for breast cancer the expected "normative" symptom experience. This in turn would allow women to anticipate symptoms, employ management strategies, and empower them to improve their cancer experience.

Activities of Daily Living↗

An instrument to measure symptom experience. Symptom occurrence and symptom distress.

This article describes the development of an instrument that measures symptom experience (symptom occurrence and symptom distress). The Adapted Symptom Distress Scale-2 (ASDS-2), adapted from the McCorkle and Young Distress Scale, is a 31-item, 5-point, self-report paper-and-pencil instrument that measures patients' perception of the occurrence and distress of 14 symptoms: nausea, vomiting, pain, eating, sleep, fatigue, bowel elimination, breathing, coughing, concentration, lacrimation, changes in body temperature, appearance, and restlessness. Use of the instrument yields a total score for symptom experience, scores for symptom occurrence, scores for symptom distress, and subscale scores for six symptom categories: gastrointestinal, fatigue/restlessness, concentration, pain/discomfort, respiratory, and appearance. Reliability and validity were determined with well adults (n = 97), medical-surgical patients (n = 82), and oncology patients (n = 175). Findings revealed a Cronbach's alpha of 0.91 for symptom experience, 0.90 for symptom occurrence, and 0.76 for symptom distress. Cronbach's alpha for the subscales ranged from 0.38 for appearance symptoms to 0.83 for gastrointestinal symptoms. Inclusion of symptoms reported by patients with cancer strengthened content validity. A contrasted groups approach was used to demonstrate construct validity.

Adolescent↗

Symptom perception: psychological correlates of symptom reporting and illness behavior of women with medically unexplained gynecological symptoms.

Medically unexplained (gynecological) symptoms can be viewed as an indication of the somatization of negative emotions. Most studies regarding psychological correlates of medically unexplained gynecological symptoms have paid attention only to certain personality characteristics of women with these symptoms. In this study the reporting of physical symptoms and the resulting illness behavior is explained in terms of information processing or a perception process, i.e. the process by which people detect and interpret physical sensations as symptoms of illness (symptom perception). Symptom perception is in part determined by environmental characteristics and cognitive and emotional processes, such as variation in daily life, (coping with) emotional threat and the use of cognitive illness schemes. Differences in symptom perception and illness behavior of women with medically unexplained and explained gynecological symptoms, compared to women with medically explained gynecological symptoms and a control group, were established with the help of a questionnaire, containing a number of scales. As expected, women with medically unexplained gynecological symptoms had higher reports of common symptoms and sensations and showed also more other illness behavior than the other two groups. They reported less variation and more threat in daily life than the other two groups. These variables together with the use of illness schemes contributed most to symptom reporting of women with medically unexplained symptoms. It is concluded that defence against threat is probably an important determinant. Suggestions for further research and some practical implications are discussed.

Adolescent↗

Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation.

The main aim of this study was to investigate the patients' self-reported symptom occurrence, symptom intensity (SI), and symptom distress (SD) from admission for stem-cell transplantation (SCT) until discharge from the ward. Forty-three patients participated and data were collected at 7 different time-points by using the self-administered Symptom Frequency, Intensity, and Distress questionnaire for SCT (SFID-SCT). The results showed that symptom occurrence followed a curve on which the highest frequencies of symptoms were reported from the day of the SCT (T2) until the end of the protective care period (T5). The mean SI and SD scores became higher when the number of reported symptoms increased. Between T2 and T5, 33% to 54% of the patients reported >10 simultaneous symptoms. Symptoms reported by more than 50% of the patients during T2-T5 were tiredness, loss of appetite, mouth dryness, nausea, sleeping disturbances, diarrhea, and changes of taste. Loss of appetite, tiredness, and mouth dryness were, in descending order, the 3 symptoms reported as most intense and distressing. A statistically significantly higher SD-score was found for the patients undergoing allogeneic SCT on the day before start of the conditioning regimen, as compared to the patients undergoing autologous SCT. Patients reporting no anxiety on admission were found to have higher, mean SD-scores at the end of the hospital stay than anxious patients. The SFID-SCT questionnaire was found to give useful information not only about symptom occurrence but also about SI and SD. To use an instrument that distinguishes between these aspects of the symptom experience may help health care professionals to support the patients through the SCT-process.

Adolescent↗

Posttraumatic stress symptoms in children after mild to moderate pediatric trauma: a longitudinal examination of symptom prevalence, correlates, and parent-child symptom reporting.

BACKGROUND: Full recovery from injury may be hindered by both physical ailments and psychologic distress. Little information is available on the psychologic response of children to physical trauma, although long-term dysfunction may result if psychologic needs are not identified and addressed. This study examined the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms in children and adolescents after an acute traumatic event resulting in mild to moderate physical injury. We were also interested in analyzing the discrepancies between parent/child reporting of the child's PTSD symptomatology. Because of the paucity of research evaluating interventions for pediatric PTSD, and as a secondary objective for this study, we collected preliminary data on the effectiveness of a single-session art therapy intervention designed to reduce PTSD symptoms. METHOD: From July 1998 through October 2000, 83 children/adolescents between the ages of 7 and 17 and their caregivers were interviewed within 24 hours of hospital admission and assessed for PTSD symptomatology, trauma history, and other measures of child and family functioning. Interviews were repeated at 1 month, 6 months, and 18 months after the initial hospitalization. Patients with at least mild symptomatology at the initial interview were randomized to receive either an art therapy intervention or standard hospital services alone. RESULTS: A total of 69% of children were found to have at least mild PTSD symptoms at baseline, 57% at 1 month, 59% at 6 months, and 38% at 18 months postinjury. Younger age and the severity of parental PTSD symptoms were correlated with symptom presence in children. Parents initially underreported their child's symptom severity when compared with the child's report, but assessments converged over time. The art therapy intervention showed no sustained effects on the reduction of PTSD symptoms. CONCLUSION: The presence of PTSD symptoms in children after traumatic injury is very high. Parental distress and characteristics of the family environment appear to be more relevant to the presence of child symptoms than the family make-up, course of hospitalization, or extent of the child's injuries. Parents may not initially recognize the degree to which their children experience such symptoms. The high presence of symptoms in this population underscores the need for treatment efficacy studies and parent/medical staff education in identification of PTSD.

Adolescent↗

Explaining retrospective reports of symptoms in patients undergoing chemotherapy: anxiety, initial symptom experience, and posttreatment symptoms.

This study evaluated different perspectives on the relationship of trait anxiety to symptom report. Baseline trait anxiety was related to (a) initial symptoms reported 2 days after beginning chemotherapy, (b) posttreatment symptoms reported 2 days after cessation of medication, and (c) retrospective reports of initial symptoms (made concurrently with posttreatment reports). Associations were significant for vague psychophysiological symptoms but not for concrete visible symptoms. Path models indicated that the relationship of anxiety to retrospective report of vague symptoms was due to both enhanced encoding and facilitated recall of symptoms. Further analyses revealed, however, that this relationship reflects symptoms stability rather than anxiety-related differences in attention. Anxious and nonanxious patients appear to be equally accurate in their retrospective report of symptoms.

Adult↗

Comparison of the Danish Prostatic Symptom Score with the International Prostatic Symptom Score, the Madsen-Iversen and Boyarsky symptom indexes. ALFECH Study Group.

OBJECTIVE: To compare the Danish Prostatic Symptom Score (DAN-PSS) with the International Prostatic Symptom Score (IPSS). Madsen-Iversen and Boyarsky symptom indexes in a clinical setting, and to evaluate the potential significance of any differences in information obtained from these questionnaires. PATIENTS AND METHODS: The study comprised two substudies: in the first, 205 patients with lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction (BOO), a Madsen-Iversen score > 6 and a maximum flow rate of < 10 mL/s were randomized to receive either placebo or alfuzosin in a double-blind study of 16 weeks. The symptoms were assessed using the Madsen-Iversen, DAN-PSS and the IPSS questionnaires. In the second, 138 patients with LUTS suggestive of BOO were selected for treatment with transurethral microwave thermotherapy (TUMT, 52 degrees C for 60 min, microwave energy 200 kJ) and their symptoms assessed using the Boyarsky and the DAN-PSS questionnaires. Patients were then followed for one year. Rank correlation coefficients and regression lines were calculated using Spearman's non-parametric test. The relative changes, i.e. responsiveness, calculated for the DAN-PSS, IPSS and Boyarsky indexes were compared pairwise using the Wilcoxon-Pratt test. RESULTS: The DAN-PSS, IPSS and Madsen-Iversen indexes were correlated on a pairwise basis. The DAN-PSS and IPSS indexes have significant construct validity in terms of correlation with the Madsen-Iversen system (Spearman's correlation coefficient, rs = 0.51 and rs = 0.45, respectively). The DAN-PSS and the IPSS indexes were correlated (rs = 0.61). The DAN-PSS was more sensitive than the IPSS to changes after pharmacological treatment, with scores decreasing 70% and 29% (P < 0.05), respectively, after treatment with an alpha-blocker for 4 months, and 50% and 29% (P < 0.05), respectively, after 4 months on placebo treatment. Finally, the responsiveness of the Boyarsky and DAN-PSS indexes to TUMT showed that the DAN-PSS system was significantly more responsive than the Boyarsky index, with scores decreasing 57% and 15% (P < 0.05), respectively, after one year. CONCLUSIONS: The DAN-PSS index is more sensitive than the IPSS, Madsen-Iversen and Boyarsky symptom indexes, incorporates important outcome events, includes a patient-weighting of each symptom, thereby reflecting better the patients' global assessment of outcome.

Adrenergic alpha-Antagonists↗

Life events do not predict symptoms: symptoms predict symptoms.

The effects of life events and previous symptoms on current symptom levels were examined in a model using data from a 3-year prospective study. Male psychiatric patients and nonpatients reported on life events and symptoms every 2 months on 18 occasions. Logistic regression analysis of these data revealed little dependence of psychiatric symptoms on preceding life events as measured by the Holmes and Rahe Schedule of Recent Experiences (SRE). The best predictor of the current symptom level was the level of previous symptoms. It is concluded that efforts to relate changes in the social environment to health must first consider the possible contribution of the antecedent symptom level to the variability in health outcome.

Adult↗

Positive and negative symptoms in the psychoses: principal components analysis of items from the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms.

The present study investigated the factor structure of the items contained in Andreasen's scales for the assessment of positive and negative symptoms (SAPS and SANS) by use of a series of principal components analyses (PCAs) with oblique rotations of the axes. It was found that the structure could be summarized by three major components labeled negative symptoms, thought disorder, and delusions/hallucinations. Dimensionality could meaningfully be increased to five components. Negative symptoms was found to separate into two components that we labeled negative signs and social dysfunctions. The delusions/hallucinations factor could be separated into two components, delusions and hallucinations, with "loss of boundary" delusions being related to both factors. Delusions of persecution were independent of other symptoms. The thought disorder factor did not decompose meaningfully within the investigated dimensionality. A two-factor solution did not explain the correlation between symptoms adequately. The results do not support the simple dichotomy between positive and negative symptoms in psychosis, but suggest that a wider dimensional concept may be more useful in future studies.

Delusions↗

Dimensionality of posttraumatic stress symptoms: a confirmatory factor analysis of DSM-IV symptom clusters and other symptom models.

Recent exploratory [Taylor, S., Kuch, K., Koch, W. J., Crockett, D. J., & Passey, G. (1998). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 107, 154-160.] and confirmatory [Buckley, T. C., Blanchard, E. B., & Hickling, E. J. (1998). A confirmatory factor analysis of posttraumatic stress symptoms. Behaviour Research and Therapy, 36, 1091-1099; King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90-96.] factor analytic investigations suggest that the three symptom clusters of posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual [4th ed.; DSM-IV; American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.] may not provide the best conceptualization of symptom dimensionality. However, the alternative models have not been in agreement, nor have they been compared against each other or models based on the DSM-IV. The purpose of the present investigation was to test a series of dimensional models suggested by these recent factor analytic investigations and the DSM-IV. Using data collected with the PTSD Checklist--Civilian Version [Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). PCL-C for DSM-IV. Boston: National Center for PTSD--Behavioral Science Division.] from 349 referrals to a primary care medical clinic, we used confirmatory factor analysis to evaluate a: (1) hierarchical four-factor model, (2) four-factor intercorrelated model, (3) hierarchical three-factor model, (4) three-factor intercorrelated model, and (5) hierarchical two-factor model. The hierarchical four-factor model (comprising four first-order factors corresponding to reexperiencing, avoidance, numbing, and hyperarousal all subsumed by a higher-order general factor) provided the best overall fit to the data; although, all models met some standards specified for good model fit. More research is needed to establish the dimensional nature of PTSD symptoms and to assess whether identified dimensions differ as a function of the trauma experience. Implications for assessment, diagnosis, and treatment are also discussed.

Adult↗

Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (Atrial fibrillation symptoms mediated by pacing to mean rates [AF SYMPTOMS study]).

The aim of this study was to investigate the effect of the Ventricular Response Pacing (VRP) algorithm, which regularizes ventricular rate during atrial fibrillation (AF), on symptoms, quality of life, and functional capacity. VRP regularizes the ventricular rate during AF without increasing the mean ventricular rate, thereby reducing the severity of AF-related symptoms in patients with persistent AF. However, VRP did not improve general quality of life (Medical Outcomes Study 36-item Short-Form General Health Survey), the performance of routine activities (Duke Activity Status Index), or functional capacity (hall walk) in patients with AF.

Aged↗

Symptom clusters: the new frontier in symptom management research.

The majority of clinical studies on pain, fatigue, and depression associated with cancer are focused on one symptom. Although this approach has led to some advances in our understanding of a particular symptom, patients rarely present with a single symptom. Therefore, even though research focused on single symptoms needs to continue, it is imperative that symptom management research begins to focus on evaluating multiple symptoms, using cross-sectional and longitudinal study designs. In addition, research needs to focus on evaluating the relationships among multiple symptoms, specific interventions, and patient outcomes. One of the initial challenges in research regarding multiple symptoms is the terminology that should be used to describe the concept (e.g., symptom cluster, symptom constellation). Another significant area related to this aspect of symptom management research is determining the nature of clinically significant clusters of symptoms and their associated prevalence rates. Equally important is the need to determine what types of tools/instruments will provide the most valid and reliable data for the assessment of symptom clusters. Other areas that need to be considered as related to the assessment of symptom clusters include the establishment of cut points for symptom severity that would qualify a symptom for inclusion in a cluster; the focus of the assessment; and the choice of the outcome measures that will be used to judge the effect of a symptom cluster on the patient. In the area of intervention studies for symptom clusters, research will need to build on the limited number of clinical trials with single symptoms. Additional considerations related to research on symptom clusters include the determination of the mechanisms underlying the development of symptom clusters; the timing of the measurements for symptom clusters; and statistical challenges in the evaluation of symptom clusters. Research on symptom clusters in patients with cancer is cutting-edge science and a new frontier in symptom management research, and it needs to be done in tandem with research on single symptoms.

Clinical Trials as Topic↗

'Prostate-related symptoms' in Canadian men 50 years of age or older: prevalence and relationships among symptoms.

OBJECTIVES: To determine the prevalence of symptoms associated with benign prostatic hyperplasia (BPH) in Canadian men, and to establish whether the traditional separation of these symptoms into obstructive and irritative categories is valid. SUBJECTS AND METHODS: A probability sample of 508 Canadian men 50 years of age or older was surveyed by telephone. The survey questions and scoring system used were devised to allow estimation of symptom prevalence and were based on the frequency and severity of the symptoms. Using the data from respondents who had moderate to severe symptoms, a cluster analysis was utilized to analyse relationships among symptoms. RESULTS: The most prevalent symptoms were nocturia (63%), weak stream (61%) and urinary frequency (46%). Urgency was reported by 18%, a sense of incomplete bladder emptying by 23%, intermittency by 18% and hesitancy by 13%. Using predefined cutoff scores, 23% of the respondents experienced moderate to severe symptoms associated with BPH; the prevalence of moderate to severe symptoms increased with age. The clusters were grouped on the basis of the symptoms driving them, with one cluster designated as 'moderates', two clusters designated as 'irritatives' and two designated as 'obstructives'. The moderates cluster was driven by respondents who had lower symptom scores evenly distributed across all symptoms. The irritatives and obstructives clusters were driven by respondents with higher scores for symptoms considered by convention to be irritative or obstructive in nature and, thus, were designated accordingly. Not all symptoms were discriminatory for irritative and obstructive symptom domains. CONCLUSIONS: A large percentage of Canadian men 50 years of age or older experience symptoms commonly associated with BPH. The theoretical concept of irritative and obstructive symptom domains was supported partially by the cluster analysis. A clear typology of men with BPH symptoms could prove useful if treatments were found to be more effective for certain types of BPH symptoms. Thus these observations warrant further investigation into the differential effects of management approaches for BPH symptoms according to symptom clusters.

Age Factors↗

Prevalence of atypical symptoms and their association with typical symptoms of gastroesophageal reflux in Spain.

BACKGROUND: The association between typical and atypical symptoms of gastroesophageal reflux (GER) has received little attention in population-based studies. This study therefore sought to examine the prevalence of atypical symptoms, and their association with typical GER symptoms in Spain. METHODS: A telephone survey using a validated questionnaire was conducted in 2002 on 2500 subjects aged 40-79 years, randomly selected from the general population of Spain. The questionnaire included items on typical GER symptoms (heartburn and acid regurgitation) and several atypical symptoms (chest pain, dysphagia, belching, dyspepsia, globus, hoarseness, hiccups, chronic cough and asthma). The association between typical GER symptoms and each atypical symptom was summarized using odds ratios obtained from logistic regression. RESULTS: The response rate was 71.2%. A total of 60.8% (95% confidence interval 59.0-62.8%) of subjects reported suffering from at least one atypical symptom during the year preceding the interview. The prevalence rates varied from 26.7% for hoarseness to 6.6% for asthma. The prevalence of atypical symptoms was higher among the 791 subjects with typical GER symptoms than among the 1709 subjects reporting no typical GER symptoms (79.6 versus 52.2%). It was also higher among those reporting frequent typical GER symptoms compared with those reporting occasional symptoms (87.8 versus 58%). After adjustment for age, sex, coffee, alcohol and tobacco consumption, and psychosomatic symptoms, an association (P<0.05) was observed between typical symptoms and the respective atypical symptoms, with odds ratios ranging from 1.4 for asthma to 4.6 for belching. After additional adjustment for the remaining atypical symptoms, chest pain, dysphagia, dyspepsia, belching and globus were each independently associated with typical reflux symptoms. CONCLUSION: The prevalence of atypical GER symptoms is extremely high. There is an association between typical and atypical GER symptoms, particularly chest pain, dysphagia, dyspepsia, belching and globus.

Adult↗

[A theory explaining the relation between "egorrhea symptoms" and "symptoms of being influenced" more efficiently than the existing theories--from the viewpoint of "experiencial type" as opposed to symptomatological direction].

Fujinawa, A. and his co-researchers have categorized symptoms of ego disorder into two opposing symptoms; "egorrhea symptoms" having the direction of "Inside to Outside" in their symptomatological structure and "symptoms of being influenced" having the direction of "Outside to Inside". They have also proposed, for ideal cases, the following: (1) "Egorrhea symptoms" are schizophrenic ego disorders. (2) These two types of symptoms are independent and opposing series of ego disorder. (3) There exists a new entity named "egorrhea type of schizophrenia" which is mainly characterized by "egorrhea symptoms" and opposed to the common type of schizophrenia which is mainly characterized by "symptoms of being influenced". The author, however, indicated several faults in their propositions and revised them from their same viewpoint. The author then proposed, from the viewpint of intentionality, the following: (1) Any symptom exhibits one of two opposite direction of intentionality; one exhibits intentionality to an object ("object experiencial type") and the other exhibits intentionality to the subject itself ("subject experiencial type"). (2) Symptoms of each "experiencial type" are related to each other and therefore make the state be composed mainly of them. The author attempted to compare his theory with Fujinawa. A. and his co-researchers theory and the revised one. 58 hallucinatory-delusional cases (29 schizophrenic cases, 29 non-schizophrenic cases) were examined. Some results were as follows: (1) "Egorrhea symptoms" are not peculiar to schizophrenia. (2) A special type of auditory hallucination, which occurs when the patient sees others, is statistically related to "egorrhea symptoms". (3) The other common type of auditory hallucination, which occurs when the patient cannot see others, is statistically related to "symptoms of being influenced". The theory proposed by the author explains these results satisfactorily compared with the former two theories. That is, (1) is not against the theory, and (2) is considered to be caused by the relation between the special type of auditory hallucination and "egorrhea symptoms" having the same object experiencial type of symptoms, and (3) is considered to be caused by the relation between the common type of auditory hallucination and "symptom of being influenced" having the same subject experiencial type of symptoms. The author further deduced the developmental series of symptoms and states from his theory and examined them with the data from the above 58 cases and other cases reported by other researchers. As a result, much of the data was successfully explained by his theory.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Symptom Networks and Core Symptoms in Patients with Solid Tumors Undergoing Chemotherapy: A Systematic Review.

OBJECTIVES: To summarize symptom network characteristics in patients with solid tumors undergoing chemotherapy and synthesize evidence on core symptoms, bridge symptoms, and temporal associations. METHODS: We systematically searched eight databases through October 2025 to identify studies that applied symptom network analysis to adults with solid tumors receiving chemotherapy. Eligible studies assessed symptoms using cross-sectional, longitudinal, or interventional designs. Two reviewers independently screened articles and extracted data on study characteristics, symptom assessment, and network outcomes. Methodological quality was assessed using the National Institutes of Health Study Quality Assessment Tool. RESULTS: Twenty-seven studies involving 13,452 participants were included, yielding 79 symptom networks. Fatigue was the most frequently identified core symptom (10/20, 50%), whereas sadness, lack of appetite, and nausea each occurred in 10% of studies, with variation across cancer types, treatment phases, and latent classes. Bridge symptoms included disturbed sleep, lack of appetite, and dry mouth (2/7, 28.6%). Studies evaluating temporal associations found that symptoms such as sadness, dyspnea, somnolence, and dry mouth predicted subsequent changes in appetite, distress, nausea, and other outcomes. Strength metrics showed acceptable stability (correlation stability coefficients: 0.28-0.83). CONCLUSIONS: Fatigue was frequently identified as a central symptom across studies, largely reflecting evidence from breast cancer studies. Core symptoms varied across cancer types, treatment phases, and latent classes, suggesting heterogeneity. IMPLICATIONS FOR NURSING PRACTICE: These findings highlight the importance of considering relationships among symptoms in clinical care. Focusing on key symptoms such as fatigue, while tailoring management strategies to cancer-specific symptom patterns, may support more effective symptom management.

Humans↗

Symptom and quality of life survey of medical oncology patients at a veterans affairs medical center: a role for symptom assessment.

BACKGROUND: The current study was conducted to assess symptom prevalence and symptom intensity and their relation to quality of life in medical oncology patients at a Veterans Affairs medical center. METHODS: Consecutive inpatients and outpatients were asked to complete the Functional Assessment Cancer Therapy (FACT-G), Memorial Symptom Assessment Scale (MSAS), and the Brief Pain Inventory. Symptoms then were analyzed by their relation to Karnofsky performance status (KPS) and quality of life. RESULTS: Two hundred forty patients participated. The median number of symptoms was 8 per patient (range, 0-30 symptoms). The 5 most prevalent symptoms were lack of energy (62%), pain (59%), dry mouth (54%), shortness of breath (50%), and difficulty sleeping (45%). Patients with moderate intensity pain had a median number of 11 symptoms and patients with moderate intensity lack of energy had a median number of 13 symptoms. The number of intense symptoms increased as the KPS decreased (P < 0.001). Patients with moderately intense pain or fatigue also were more likely to experience nausea, dyspnea, and lack of appetite. The number of symptoms rated as present on the MSAS was found to correlate significantly with the FACT-G Sum Quality of Life score. CONCLUSIONS: Intense symptoms were highly prevalent in this population. The presence of pain, lack of energy, or poor performance status should lead to comprehensive symptom assessment. Patients free of disease nevertheless still may experience intense symptoms. The number of symptoms present may be a helpful guide to quality of life. Routine comprehensive symptom assessment may identify a significant fraction of patients who urgently require intensive symptom palliation.

Activities of Daily Living↗

Using the symptom monitor in a randomized controlled trial: the effect on symptom prevalence and severity.

This randomized controlled trial investigated the effect of reporting physical symptoms by using a systematic symptom monitoring instrument, the Symptom Monitor, on symptom prevalence and severity among patients with cancer in the palliative phase. The overall objective was to achieve symptom relief through systematic and regular symptom reporting by patients themselves. One hundred forty-six patients with cancer in the palliative phase were randomized to either the intervention group (n = 69 with Symptom Monitor) or the control group (n = 77 without Symptom Monitor). Ten physical symptoms with regard to prevalence and severity were monitored. After 2 months, the prevalence of symptoms was lower in the intervention group compared to the control group (prevalent differences 2.1-24.3%) for 9 out of 10 symptoms (except coughing). The intervention group scored a statistically significantly lower prevalence in constipation and vomiting (prevalence differences 24.3% and 18.0%, respectively). In four symptoms (fatigue, lack of appetite, shortness of breath, and nausea), the intervention group had a lower, although not statistically significant, severity score (median differences 0.5-1). In four symptoms (pain, coughing, sleeplessness, and diarrhea), the severity score was the same in both groups (medians 2-4). In two symptoms (constipation and vomiting), the severity score was lower in the control group (median differences -1 and -2). A comparison between the study groups on improved, deteriorated, or steady-state cases showed that the severity score had deteriorated less for 8 out of 10 symptoms in a larger proportion of patients in the intervention group. Although statistical significance was not reached, the prevalence as well as severity of symptoms in the palliative phase of cancer can be influenced by using the Symptom Monitor.

Aged↗