Eun Joo Yang1, Keun Seok Lee2, Myong Cheol Lim3, Ji Yeon Baek4, Ji-Youn Han5, Eun-Seung Yu6, Seung Hyun Chung7. 1. Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Department of Internal Medicine, Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 3. Department of Obstetrics and Gynecology, Division of Tumor Immunology, Center for Uterine Cancer, and Center for Clinical Trials, National Cancer Center, Goyang, Republic of Korea. 4. Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 5. Department of Internal Medicine, Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 6. Department of Psychiatry & Behavioral Science, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 7. Department of Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Abstract
PURPOSE: To explore how symptom perception affects functioning in patients with advanced cancer. MATERIALS AND METHODS: We conducted a cross-sectional observational study of 459 advanced cancer patients at the national cancer center. Functioning was assessed using the World Health Organization Disability Assessment Schedule (WHODAS) II, and symptoms were evaluated using the Memorial Symptom Assessment Scale-Short Form. Confirmatory factor analysis was conducted to develop a structural model based on different symptom perceptions, such as somatic sensation and experienced symptoms. RESULTS: The structural model of disability revealed a significant direct pathway involving somatic sensation (β = 16.11, p < 0.001). Experienced symptoms significantly affected somatic sensations (β = 0.717, p < 0.001) but were not directly associated with disability. Unidimensional models exhibited a poor fit. In contrast, a complex model with first-order (somatic sensation) and second-order (experienced symptoms) factors provided an excellent fit, with comparative fit indexes (CFIs) and Tucker Lewis indexes (TLI) of more than 0.950 threshold. CONCLUSIONS: Our findings suggest that relationships to functioning may vary between somatic sensations versus experienced symptoms. The structure of symptoms is best conceptualized by direct somatic sensation and indirect experienced symptoms. A better understanding of symptom perception and the relationship between symptoms and function would facilitate the development of effective rehabilitation programs.
PURPOSE: To explore how symptom perception affects functioning in patients with advanced cancer. MATERIALS AND METHODS: We conducted a cross-sectional observational study of 459 advanced cancerpatients at the national cancer center. Functioning was assessed using the World Health Organization Disability Assessment Schedule (WHODAS) II, and symptoms were evaluated using the Memorial Symptom Assessment Scale-Short Form. Confirmatory factor analysis was conducted to develop a structural model based on different symptom perceptions, such as somatic sensation and experienced symptoms. RESULTS: The structural model of disability revealed a significant direct pathway involving somatic sensation (β = 16.11, p < 0.001). Experienced symptoms significantly affected somatic sensations (β = 0.717, p < 0.001) but were not directly associated with disability. Unidimensional models exhibited a poor fit. In contrast, a complex model with first-order (somatic sensation) and second-order (experienced symptoms) factors provided an excellent fit, with comparative fit indexes (CFIs) and Tucker Lewis indexes (TLI) of more than 0.950 threshold. CONCLUSIONS: Our findings suggest that relationships to functioning may vary between somatic sensations versus experienced symptoms. The structure of symptoms is best conceptualized by direct somatic sensation and indirect experienced symptoms. A better understanding of symptom perception and the relationship between symptoms and function would facilitate the development of effective rehabilitation programs.
Authors: Carolyn Miller Reilly; Deborah Watkins Bruner; Sandra A Mitchell; Lori M Minasian; Ethan Basch; Amylou C Dueck; David Cella; Bryce B Reeve Journal: Support Care Cancer Date: 2013-01-12 Impact factor: 3.603