Patsy Yates1, Christine Miaskowski2, Janine K Cataldo2, Steven M Paul2, Bruce A Cooper2, Kimberly Alexander1, Bradley Aouizerat3, Laura Dunn4, Christine Ritchie4, Alexandra McCarthy1, Helen Skerman5. 1. School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. 2. School of Nursing, University of California, San Francisco, California, USA. 3. School of Nursing, University of California, San Francisco, California, USA; Institute for Human Genetics, University of California, San Francisco, California, USA. 4. School of Medicine, University of California, San Francisco, California, USA. 5. School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. Electronic address: h.skerman@qut.edu.au.
Abstract
CONTEXT: Older oncology patients have unique needs associated with the many physical, psychological, and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences. OBJECTIVES: The purposes of this study were to identify and compare symptom clusters in younger (<60 years) and older (≥60 years) patients undergoing cancer treatment. METHODS: Symptom data from one Australian study and two U.S. studies were combined to conduct this analysis. A total of 593 patients receiving active treatment were dichotomized into younger (<60 years) and older (≥60 years) groups. Separate exploratory factor analyses (EFAs) were undertaken within each group to identify symptom clusters from occurrence ratings of the 32 symptoms assessed by the Memorial Symptom Assessment Scale. RESULTS: In both groups, a seven-factor solution was selected. Four partially concordant symptom clusters emerged in both groups (i.e., mood/cognitive, malaise, body image, and genitourinary). In the older patients, the three unique clusters reflected physiological changes associated with aging, whereas in the younger group the three unique clusters reflected treatment-related effects. CONCLUSION: The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.
CONTEXT: Older oncology patients have unique needs associated with the many physical, psychological, and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences. OBJECTIVES: The purposes of this study were to identify and compare symptom clusters in younger (<60 years) and older (≥60 years) patients undergoing cancer treatment. METHODS: Symptom data from one Australian study and two U.S. studies were combined to conduct this analysis. A total of 593 patients receiving active treatment were dichotomized into younger (<60 years) and older (≥60 years) groups. Separate exploratory factor analyses (EFAs) were undertaken within each group to identify symptom clusters from occurrence ratings of the 32 symptoms assessed by the Memorial Symptom Assessment Scale. RESULTS: In both groups, a seven-factor solution was selected. Four partially concordant symptom clusters emerged in both groups (i.e., mood/cognitive, malaise, body image, and genitourinary). In the older patients, the three unique clusters reflected physiological changes associated with aging, whereas in the younger group the three unique clusters reflected treatment-related effects. CONCLUSION: The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.
Authors: Komal Singh; Kord M Kober; Steven M Paul; Marilyn Hammer; Fay Wright; Yvette P Conley; Jon D Levine; Christine Miaskowski Journal: Support Care Cancer Date: 2019-08-19 Impact factor: 3.603
Authors: Jacquelyn Russell; Melisa L Wong; Lynda Mackin; Steven M Paul; Bruce A Cooper; Marilyn Hammer; Yvette P Conley; Fay Wright; Jon D Levine; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2019-02-13 Impact factor: 3.612
Authors: Carmen W Sullivan; Heather Leutwyler; Laura B Dunn; Bruce A Cooper; Steven M Paul; Jon D Levine; Marilyn Hammer; Yvette P Conley; Christine A Miaskowski Journal: J Pain Symptom Manage Date: 2017-08-31 Impact factor: 3.612
Authors: Carmen Ward Sullivan; Heather Leutwyler; Laura B Dunn; Bruce A Cooper; Steven M Paul; Yvette P Conley; Jon D Levine; Christine A Miaskowski Journal: Eur J Oncol Nurs Date: 2017-04-26 Impact factor: 2.398
Authors: Claire J Han; Kerryn Reding; Bruce A Cooper; Steven M Paul; Yvette P Conley; Marilyn Hammer; Kord M Kober; Jon D Levine; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2019-08-09 Impact factor: 3.612
Authors: Claire J Han; Kerryn Reding; Bruce A Cooper; Steven M Paul; Yvette P Conley; Marilyn Hammer; Fay Wright; Frances Cartwright; Jon D Levine; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2019-05-09 Impact factor: 3.612