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System, Lung cancer, Patient, Assessment scale, Fatigue, Validation, Depression, Anorexia, Pain, Anxiety

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Subject-Keyword: System Lung cancer Patient Assessment scale Fatigue Validation Depression Anorexia Pain Anxiety

Type of item: Journal Article Published

Language: English

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Description: Background: Symptoms tend to occur in what have been called symptom clusters. Early symptom cluster research was imprecise regarding the causal foundations of the coordinations between specific symptoms, and was silent on whether the relationships between symptoms remained stable over time. This study develops a causal model of the relationships between symptoms in cancer palliative care patients as they approach death, and investigates the changing associations among the symptoms and between those symptoms and well-being. Methods: Complete symptom assessment scores were obtained for 82 individuals from an existing palliative care database. The data included assessments of pain, anxiety, nausea, shortness of breath, drowsiness, loss of appetite, tiredness, depression and well-being, all collected using the Edmonton Symptom Assessment System ESAS. Relationships between the symptoms and wellbeing were investigated using a structural equation model. Results: The model fit acceptably and explained between 26% and 83% of the variation in appetite, tiredness, depression, and well-being. Drowsiness displayed consistent effects on appetite, tiredness and well-being. In contrast, anxiety-s effect on well-being shifted importantly, with a direct effect and an indirect effect through tiredness at one month, being replaced by an effect working exclusively through depression at one week. Conclusion: Some of the causal forces explaining the variations in, and relationships among, palliative care patients- symptoms changed over the final month of life. This illustrates how investigating the causal foundations of symptom correlation or clustering can provide more detailed understandings that may contribute to improved control of patient comfort, quality of life, and quality of death.

Date created: 2008

DOI: doi:10.7939-R3B56Z

License information: Creative Commons Attribution 3.0 Unported

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Autor: Olson, K. Hayduk, L. Cree, M. Cui, Y. Quan, H. Hanson, J. Lawlor, P. Strasser, F.

Fuente: https://era.library.ualberta.ca/


Introducción



BMC Medical Research Methodology BioMed Central Open Access Research article The changing causal foundations of cancer-related symptom clustering during the final month of palliative care: A longitudinal study Karin Olson*1, Leslie Hayduk2, Marilyn Cree1, Ying Cui3, Hue Quan4, John Hanson5, Peter Lawlor6,7 and Florian Strasser8,9 Address: 1Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada, 2Sociology Department, University of Alberta, Edmonton, Alberta, Canada, 3Faculty of Education, University of Alberta, Edmonton, Alberta, Canada, 4Capital Health Regional Palliative Care Program, Edmonton, Alberta, Canada, 5Cross Cancer Institute, Edmonton, Alberta, Canada, 6Our Ladys Hospice, Harolds Cross, Dublin, Ireland, 7Division of Palliative Care Medicine, Dept of Oncology, University of Alberta, Edmonton, Alberta, Canada, 8Oncological Palliative Medicine, Section Oncology, Dept Internal Medicine, Cantonal Hospital, St.
Gallen, Switzerland and 9Palliative Care Center, Dept Internal Medicine, Cantonal Hospital, St.
Gallen, Switzerland Email: Karin Olson* - karin.olson@ualberta.ca; Leslie Hayduk - lhayduk@ualberta.ca; Marilyn Cree - mcree@ualberta.ca; Ying Cui - yc@ualberta.ca; Hue Quan - hquan@cha.ab.ca; John Hanson - johnqhanson@yahoo.com; Peter Lawlor - PLawlor@olh.ie; Florian Strasser - fstrasser@bluewin.ch * Corresponding author Published: 4 June 2008 BMC Medical Research Methodology 2008, 8:36 doi:10.1186-1471-2288-8-36 Received: 22 February 2008 Accepted: 4 June 2008 This article is available from: http:--www.biomedcentral.com-1471-2288-8-36 © 2008 Olson et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http:--creativecommons.org-licenses-by-2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Symptoms tend to occur in what have been called symptom clust...





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