Mary E Medysky1, Nathan F Dieckmann, Kerri M Winters-Stone, Donald R Sullivan, Karen S Lyons. 1. Author Affiliations: School of Nursing (Ms Medysky and Drs Dieckmann and Winters-Stone), Knight Cancer Institute (Drs Winters-Stone and Sullivan), and Division of Pulmonary and Critical Care Medicine, Department of Medicine (Dr Sullivan), Oregon Health & Science University, Portland; and Health Services & Research Development, Veterans Affairs Portland Health Care System, Oregon (Dr Sullivan); and Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Lyons).
Abstract
BACKGROUND: Lung cancer survivors are at risk of accelerated declines in physical functioning attributed to cancer treatment. However, it is unknown whether patients experience the same rate of functional decline and how symptoms may contribute to different trajectories. OBJECTIVES: The aims of this study were to identify interindividual differences in the pattern and rate of change in self-reported functioning in lung cancer survivors and examine whether and how symptoms are related to physical functioning over time. METHODS: This was a secondary data analysis in 72 lung cancer survivors. Multilevel modeling was used to estimate trajectories of self-reported physical functioning over 1 year and assess the relation between functioning, fatigue, depressive symptoms, and pain severity across time. RESULTS: Within the sample, average physical functioning did not significantly decrease (coefficient, -0.46; 95% confidence interval [CI] = -2.85 to 0.94) over time. However, among individual lung cancer survivors, baseline physical functioning varied significantly (SD, 20.76; 95% CI, 16.84-25.59) and changed at significantly different rates over 1 year (SD, 3.50; 95% CI, 2.13-5.68). Fatigue, assessed over 1 year, was the only significant symptom predictor of physical functioning changes over time (coefficient = 1.03; 95% CI, 0.79-1.27). CONCLUSIONS: In this sample of lung cancer survivors, not all survivors experienced the same rate of self-reported functional decline and those with lower levels of fatigue reported better physical functioning. IMPLICATIONS FOR PRACTICE: Nurses should recognize that some lung cancer survivors may have faster rates of functional declines than others, which may be related to fatigue severity. Early identification and management of fatigue could help avoid or delay future disability.
BACKGROUND: Lung cancer survivors are at risk of accelerated declines in physical functioning attributed to cancer treatment. However, it is unknown whether patients experience the same rate of functional decline and how symptoms may contribute to different trajectories. OBJECTIVES: The aims of this study were to identify interindividual differences in the pattern and rate of change in self-reported functioning in lung cancer survivors and examine whether and how symptoms are related to physical functioning over time. METHODS: This was a secondary data analysis in 72 lung cancer survivors. Multilevel modeling was used to estimate trajectories of self-reported physical functioning over 1 year and assess the relation between functioning, fatigue, depressive symptoms, and pain severity across time. RESULTS: Within the sample, average physical functioning did not significantly decrease (coefficient, -0.46; 95% confidence interval [CI] = -2.85 to 0.94) over time. However, among individual lung cancer survivors, baseline physical functioning varied significantly (SD, 20.76; 95% CI, 16.84-25.59) and changed at significantly different rates over 1 year (SD, 3.50; 95% CI, 2.13-5.68). Fatigue, assessed over 1 year, was the only significant symptom predictor of physical functioning changes over time (coefficient = 1.03; 95% CI, 0.79-1.27). CONCLUSIONS: In this sample of lung cancer survivors, not all survivors experienced the same rate of self-reported functional decline and those with lower levels of fatigue reported better physical functioning. IMPLICATIONS FOR PRACTICE: Nurses should recognize that some lung cancer survivors may have faster rates of functional declines than others, which may be related to fatigue severity. Early identification and management of fatigue could help avoid or delay future disability.
Authors: Carolyn J Presley; Nicole A Arrato; Peter G Shields; David P Carbone; Melisa L Wong; Jason Benedict; Sarah A Reisinger; Ling Han; Thomas M Gill; Heather Allore; Barbara L Andersen; Sarah Janse Journal: JTO Clin Res Rep Date: 2022-05-17