Katarina Jakovljevic1, Kord M Kober1, Astrid Block1, Bruce A Cooper1, Steven M Paul1, Marilyn J Hammer2, Frances Cartwright3, Yvette P Conley4, Fay Wright5, Laura B Dunn6, Jon D Levine7, Christine Miaskowski8. 1. School of Nursing, University of California, San Francisco, California, USA. 2. Dana Farber Cancer Center, Boston, Massachusetts, USA. 3. Mount Sinai Medical Center, New York, New York, USA. 4. School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 5. Rory Meyers College of Nursing, New York University, New York, New York, USA. 6. School of Medicine, Stanford University, Stanford, California, USA. 7. School of Medicine, University of California, San Francisco, California, USA. 8. School of Nursing, University of California, San Francisco, California, USA. Electronic address: chris.miaskowski@ucsf.edu.
Abstract
CONTEXT: A cancer diagnosis and associated treatments, as well as the uncertainty of the disease course, are stressful experiences for most patients. However, little information is available on the relationship between stress and symptom burden. OBJECTIVES: The study purpose was to evaluate for differences in the severity of fatigue, lack of energy, sleep disturbance, and cognitive function, among three groups of patients with distinct stress profiles. METHODS: Patients receiving chemotherapy (n = 957) completed measures of general, cancer-specific, and cumulative life stress and symptom inventories. Latent profile analysis was used to identify subgroups of patients with distinct stress profiles. RESULTS: Three distinct subgroups of patients were identified (i.e., stressed [39.3%], normative [54.3%], resilient [5.7%]). For cognitive function, significant differences were found among the latent classes (stressed < normative < resilient). For both sleep disturbance and morning and evening fatigue, compared to the normative and resilient classes, the stressed class reported higher severity scores. Compared to the normative and resilient classes, the stressed class reported low levels of morning energy. Compared to the normative class, the stressed class reported lower levels of evening energy. CONCLUSIONS: Consistent with our a priori hypothesis, patients in the stressed class had the highest symptom severity scores for all four symptoms and all these scores were above the clinically meaningful cutoffs for the various instruments.
CONTEXT: A cancer diagnosis and associated treatments, as well as the uncertainty of the disease course, are stressful experiences for most patients. However, little information is available on the relationship between stress and symptom burden. OBJECTIVES: The study purpose was to evaluate for differences in the severity of fatigue, lack of energy, sleep disturbance, and cognitive function, among three groups of patients with distinct stress profiles. METHODS: Patients receiving chemotherapy (n = 957) completed measures of general, cancer-specific, and cumulative life stress and symptom inventories. Latent profile analysis was used to identify subgroups of patients with distinct stress profiles. RESULTS: Three distinct subgroups of patients were identified (i.e., stressed [39.3%], normative [54.3%], resilient [5.7%]). For cognitive function, significant differences were found among the latent classes (stressed < normative < resilient). For both sleep disturbance and morning and evening fatigue, compared to the normative and resilient classes, the stressed class reported higher severity scores. Compared to the normative and resilient classes, the stressed class reported low levels of morning energy. Compared to the normative class, the stressed class reported lower levels of evening energy. CONCLUSIONS: Consistent with our a priori hypothesis, patients in the stressed class had the highest symptom severity scores for all four symptoms and all these scores were above the clinically meaningful cutoffs for the various instruments.
Authors: Jennifer M Knight; Mallory R Taylor; Kelly E Rentscher; Elisabeth C Henley; Hannah A Uttley; Ashley M Nelson; Lucie M Turcotte; Natalie S McAndrew; Hermioni L Amonoo; Lathika Mohanraj; Debra Lynch Kelly; Erin S Costanzo Journal: Front Immunol Date: 2022-07-05 Impact factor: 8.786
Authors: Larissa Staurengo-Ferrari; Ivan J M Bonet; Dioneia Araldi; Paul G Green; Jon D Levine Journal: J Neurosci Date: 2021-12-08 Impact factor: 6.709
Authors: Paule V Joseph; Alissa Nolden; Kord M Kober; Steven M Paul; Bruce A Cooper; Yvette P Conley; Marilyn J Hammer; Fay Wright; Jon D Levine; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2020-11-28 Impact factor: 5.576