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Purpose: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease with a high symptom burden. Data are lacking on the comparative health status of patients with CRSwNP. This analysis compared baseline physical and mental health-related quality of life (HRQoL) and overall health status of patients with severe CRSwNP enrolled in a Phase 3 clinical trial with general population norms and with other chronic diseases. Methods: In this post hoc cross-sectional analysis of baseline data from the SINUS-24 study (NCT02912468), HRQoL was measured using the 36-item Short Form (SF-36) questionnaire and general health status was measured using the EuroQol-5 Dimension visual analog scale (EQ-VAS). Analyses included the intention-to-treat (ITT) population and subgroups defined by prior sinonasal surgery, systemic corticosteroid use, and coexisting asthma or non-steroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD). Scores were compared with published values for population norms (50 for SF-36 physical component summary (PCS) and mental component summary (MCS), 70.4-83.3 for EQ-VAS) and for rheumatoid arthritis, type 2 diabetes, and asthma. Results: In the ITT population (n=276), mean SF-36 physical component summary (PCS), SF-36 mental component summary (MCS), and EQ-VAS scores were below general population norms (46.4, 48.6, and 66.0, respectively). Mean SF-36 PCS and EQ-VAS scores were below population norms across all subgroups; mean SF-36 MCS scores were below the population norm in all subgroups except no prior surgery. SF-36 PCS and MCS scores from SINUS-24 were generally similar to other chronic diseases, except SF-36 PCS which was lower in rheumatoid arthritis. EQ-VAS scores in SINUS-24 were lower than in other chronic diseases. HRQoL scores weakly correlated with objective measures of disease severity. Conclusion: In patients with severe CRSwNP, including those with coexisting asthma/NSAID-ERD, HRQoL was worse than population norms and as burdensome as diseases such as type 2 diabetes, asthma, and rheumatoid arthritis.
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Although hematologic neoplasms have been on the vanguard of cancer therapies that led to notable advances in therapeutic efficacy, many patients face significant symptom burden, which make them eligible for early palliative care (PC) integration. However, previous reports demonstrated that hematological malignancies receive more aggressive care at the end-of-life and are less likely to receive care from specialist palliative services compared to solid tumors. Our aim was to characterize symptom burden, performance status and clinical characteristics of a cohort of hematologic malignancies patients referred to PC outpatient consultation, according to their diagnosis. Fifty-nine hematological malignancies patients referred to PC consultation between January 2018 and September 2021 were included. Clinical and laboratory data were evaluated retrospectively by medical charts analysis. Patients exhibited high ESAS and reduced PPS scores at the time of PC referral. Acute leukemia and multiple myeloma patients had the highest symptom burden scores; in spite of this, median time from the first PC consultation until death was only 3 and 4 months, respectively. In conclusion, we identified that hematologic neoplasms patients are highly symptomatic and are frequently referred to PC in end stages of their disease.
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Neoplasias Hematológicas , Mieloma Múltiplo , Neoplasias , Humanos , Estudos Retrospectivos , Neoplasias Hematológicas/terapia , Neoplasias/terapia , Cuidados Paliativos , Encaminhamento e Consulta , Mieloma Múltiplo/terapiaRESUMO
Background: Anxiety and depression symptoms are known to increase cancer symptom burden, yet little is known about the longitudinal integrations of these among Hispanic/Latinx patients. The goal of this study was to explore the trajectory and longitudinal interactions among anxiety and depression, cancer symptom burden, and health-related quality of life in Hispanic/Latinx cancer patients undergoing chemotherapy. METHODS: Baseline behavioral assessments were performed before starting chemotherapy. Follow-up behavioral assessments were performed at 3, 6, and 9 months after starting chemotherapy. Descriptive statistics, chi-square tests, Fisher's exact tests, and Mann-Whitney tests explored associations among outcome variables. Adjusted multilevel mixed-effects linear regression models were also used to evaluate the association between HADS scores, follow-up visits, FACT-G scale, MDASI scale, and sociodemographic variables. RESULTS: Increased cancer symptom burden was significantly related to changes in anxiety symptoms' scores (adjusted ß^ = 0.11 [95% CI: 0.02, 0.19]. Increased quality of life was significantly associated with decreased depression and anxiety symptoms (adjusted ß^ = -0.33; 95% CI: -0.47, -0.18, and 0.38 adjusted ß^= -0.38; 95% CI: -0.55, -0.20, respectively). CONCLUSIONS: Findings highlight the need to conduct periodic mental health screenings among cancer patients initiating cancer treatment.
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AIMS: Type 2 diabetes mellitus (T2DM), serious and increasingly prevalent among Mexican Americans, produces symptoms related to high and low glucose levels, medication side effects, and long-term complications. This secondary analysis explored symptom prevalence, differences among symptom burden levels, and how symptoms clustered. METHODS: Clinical measurements and survey data (demographic, quality of life, and the symptom subscale of the Diabetes Symptom Self-Management Inventory) collected from Mexican American adults with T2DM (nâ¯=â¯71) were analyzed for symptom prevalence, differences across levels of symptom burden, and symptom clusters. Agglomerative hierarchical and k-means clustering analyses were performed on a Gower matrix. Internal validation methods and rank aggregation were used to identify the best clustering method of the two techniques and to identify symptoms that clustered together. RESULTS: Participants reported meanâ¯=â¯14 symptoms; tiredness and trouble sleeping were most prevalent. People with high symptom burden had significantly lower quality of life and perceptions of worse diabetes severity. Hierarchical clustering produced three symptom clusters: cluster 1â¯=â¯9 symptoms (e.g. intense thirstiness, dry mouth); cluster 2â¯=â¯9 symptoms (e.g., itching skin, weight gain, noise or light sensitivity); cluster 3â¯=â¯13 symptoms (e.g., nervous, headache, trouble concentrating, and memory loss). CONCLUSION: Mexican Americans with T2DM report several co-occurring symptoms. Quality of life is significantly worse for people with high symptom burden. Three distinct symptom clusters were identified. Studies with larger samples are needed to further diabetes symptom science. Clinicians should assess and address patients' co-occurring symptoms as a potential means of decreasing symptom burden and improving quality of life.
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Efeitos Psicossociais da Doença , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Adulto , Idoso , Análise por Conglomerados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Síndrome , Estados Unidos/epidemiologia , Estados Unidos/etnologiaRESUMO
BACKGROUND: Improved survival for individuals with metastatic cancer accentuates the importance of employment for cancer survivors. A better understanding of how metastatic cancer affects employment is a necessary step toward the development of tools for assisting survivors in this important realm. METHODS: The ECOG-ACRIN Symptom Outcomes and Practice Patterns study was analyzed to investigate what factors were associated with the employment of 680 metastatic cancer patients. Univariate and multivariate logistic regression analyses were conducted to compare patients stably working with patients no longer working. RESULTS: There were 668 metastatic working-age participants in the analysis: 236 (35%) worked full- or part-time, whereas 302 (45%) had stopped working because of illness. Overall, 58% reported some change in employment due to illness. A better performance status and non-Hispanic white ethnicity/race were significantly associated with continuing to work despite a metastatic cancer diagnosis in the multivariate analysis. The disease type, time since metastatic diagnosis, number of metastatic sites, location of metastatic disease, and treatment status had no significant impact. Among the potentially modifiable factors, receiving hormonal treatment (if a viable option) and decreasing symptom interference were associated with continuing to work. CONCLUSIONS: A significant percentage of the metastatic patients remained employed; increased symptom burden was associated with a change to no longer working. Modifiable factors resulting in work interference should be minimized so that patients with metastatic disease may continue working if this is desired. Improvements in symptom control and strategies developed to help address workplace difficulties have promise for improving this aspect of survivorship.
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Emprego/estatística & dados numéricos , Metástase Neoplásica , Neoplasias/complicações , Adulto , Neoplasias da Mama/complicações , Neoplasias Colorretais/complicações , Progressão da Doença , Feminino , Humanos , Modelos Logísticos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/etnologia , Neoplasias/patologia , Neoplasias/terapia , Peru/epidemiologia , Prevalência , Estudos Prospectivos , Neoplasias da Próstata/complicações , Autorrelato , Índice de Gravidade de Doença , Sobreviventes , Fatores de Tempo , Resultado do Tratamento , Estados Unidos/epidemiologia , TrabalhoRESUMO
CONTEXT: Several instruments have been developed to assess the symptom burden and fatigue produced by cancer and its treatment. However, little research has been conducted in Latin American Spanish-speaking patients. OBJECTIVES: The aim of the study was to assess the psychometric properties of the Spanish versions of two commonly used patient-reported outcome measures, the Memorial Symptom Assessment Scale-Short Form (MSAS-SF), and the fatigue subscale of the Functional Assessment of Cancer Therapy-General (FACT-G), the FACIT-Fatigue. METHODS: A classic psychometric approach was followed to assess the reliability and validity of the instruments. Responsiveness to change and effect sizes were calculated. RESULTS: The translated version of the MSAS-SF proved to be comprehensible and easy to complete. Cronbach alpha reliability coefficients ranged from acceptable to excellent for the MSAS-SF subscale scores and the FACIT-Fatigue. There was evidence of convergent validity between the physical and the psychological subscales of the instruments. The MSAS-SF could discriminate among the known groups according to Eastern Cooperative Oncology performance status and level of anemia, and showed responsiveness to change of symptom burden at two times of treatment. CONCLUSION: The study showed that both the MSAS-SF and the FACIT-Fatigue have good reliability and validity for use with patients with cancer in Uruguay. When used simultaneously, these instruments may provide a complete picture of the impact of cancer and its treatment on the patient's quality of life.