Symptom Cluster Experience Profiles in Adult Survivors of Childhood Cancers

Lorna Finnegan, Richard T. Campbell, Carol Estwing Ferrans, JoEllen Wilbur, Diana J. Wilkie, Joan L Shaver

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Although aggressive medical treatment protocols have led to 80% five-year survival rates for most childhood cancer patients, many long-term survivors experience multiple troubling symptoms. Using data from 100 adult survivors of childhood cancers (ACC-survivors), we used latent variable mixture modeling to generate unique subgroups of survivors based on their experiences with a cluster of eight symptoms: lack of energy, worry, pain, difficulty sleeping, feeling irritable, feeling nervous, difficulty concentrating, and feeling sad (as measured by the Memorial Symptom Assessment Scale). We also examined factors that were likely to predict subgroup membership (chronic health conditions [CHCs], health-promoting lifestyle, and demographic variables) and determined the extent to which satisfaction with quality of life (QoL) varied across the subgroups. The final mixture model included three subgroups of ACC-survivors: high symptoms (HS; n = 21), moderate symptoms (MS; n = 45), and low symptoms (LS; n = 34). ACC-survivors who reported at least one CHC were six times as likely to be classified in the HS subgroup as compared with the LS subgroup. Mean health-promoting lifestyle scores were lowest in the HS subgroup and highest in the LS subgroup. Differences in QoL among the subgroups were statistically significant, thus validating that the subgroups were characterized uniquely for identifying those symptoms with highest life impact. To our knowledge, we are the first to identify distinct subgroups of ACC-survivors differentiated by symptom cluster experience profiles. The findings warrant additional research to confirm the subgroup-specific symptom cluster experience profiles in larger studies of ACC-survivors.

Original languageEnglish (US)
Pages (from-to)258-269
Number of pages12
JournalJournal of Pain and Symptom Management
Volume38
Issue number2
DOIs
StatePublished - Aug 2009
Externally publishedYes

Fingerprint

Survivors
Neoplasms
Emotions
Health
Life Style
Quality of Life
Symptom Assessment
Clinical Protocols
Survival Rate
Demography
Pain
Research

Keywords

  • adult survivors of childhood cancers
  • Cancer
  • latent variable mixture models
  • oncology
  • quality of life
  • symptom cluster

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Nursing(all)

Cite this

Symptom Cluster Experience Profiles in Adult Survivors of Childhood Cancers. / Finnegan, Lorna; Campbell, Richard T.; Ferrans, Carol Estwing; Wilbur, JoEllen; Wilkie, Diana J.; Shaver, Joan L.

In: Journal of Pain and Symptom Management, Vol. 38, No. 2, 08.2009, p. 258-269.

Research output: Contribution to journalArticle

Finnegan, Lorna ; Campbell, Richard T. ; Ferrans, Carol Estwing ; Wilbur, JoEllen ; Wilkie, Diana J. ; Shaver, Joan L. / Symptom Cluster Experience Profiles in Adult Survivors of Childhood Cancers. In: Journal of Pain and Symptom Management. 2009 ; Vol. 38, No. 2. pp. 258-269.
@article{9ad3b3c7f9024ce591c244ebaa64e784,
title = "Symptom Cluster Experience Profiles in Adult Survivors of Childhood Cancers",
abstract = "Although aggressive medical treatment protocols have led to 80{\%} five-year survival rates for most childhood cancer patients, many long-term survivors experience multiple troubling symptoms. Using data from 100 adult survivors of childhood cancers (ACC-survivors), we used latent variable mixture modeling to generate unique subgroups of survivors based on their experiences with a cluster of eight symptoms: lack of energy, worry, pain, difficulty sleeping, feeling irritable, feeling nervous, difficulty concentrating, and feeling sad (as measured by the Memorial Symptom Assessment Scale). We also examined factors that were likely to predict subgroup membership (chronic health conditions [CHCs], health-promoting lifestyle, and demographic variables) and determined the extent to which satisfaction with quality of life (QoL) varied across the subgroups. The final mixture model included three subgroups of ACC-survivors: high symptoms (HS; n = 21), moderate symptoms (MS; n = 45), and low symptoms (LS; n = 34). ACC-survivors who reported at least one CHC were six times as likely to be classified in the HS subgroup as compared with the LS subgroup. Mean health-promoting lifestyle scores were lowest in the HS subgroup and highest in the LS subgroup. Differences in QoL among the subgroups were statistically significant, thus validating that the subgroups were characterized uniquely for identifying those symptoms with highest life impact. To our knowledge, we are the first to identify distinct subgroups of ACC-survivors differentiated by symptom cluster experience profiles. The findings warrant additional research to confirm the subgroup-specific symptom cluster experience profiles in larger studies of ACC-survivors.",
keywords = "adult survivors of childhood cancers, Cancer, latent variable mixture models, oncology, quality of life, symptom cluster",
author = "Lorna Finnegan and Campbell, {Richard T.} and Ferrans, {Carol Estwing} and JoEllen Wilbur and Wilkie, {Diana J.} and Shaver, {Joan L}",
year = "2009",
month = "8",
doi = "10.1016/j.jpainsymman.2008.09.010",
language = "English (US)",
volume = "38",
pages = "258--269",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Symptom Cluster Experience Profiles in Adult Survivors of Childhood Cancers

AU - Finnegan, Lorna

AU - Campbell, Richard T.

AU - Ferrans, Carol Estwing

AU - Wilbur, JoEllen

AU - Wilkie, Diana J.

AU - Shaver, Joan L

PY - 2009/8

Y1 - 2009/8

N2 - Although aggressive medical treatment protocols have led to 80% five-year survival rates for most childhood cancer patients, many long-term survivors experience multiple troubling symptoms. Using data from 100 adult survivors of childhood cancers (ACC-survivors), we used latent variable mixture modeling to generate unique subgroups of survivors based on their experiences with a cluster of eight symptoms: lack of energy, worry, pain, difficulty sleeping, feeling irritable, feeling nervous, difficulty concentrating, and feeling sad (as measured by the Memorial Symptom Assessment Scale). We also examined factors that were likely to predict subgroup membership (chronic health conditions [CHCs], health-promoting lifestyle, and demographic variables) and determined the extent to which satisfaction with quality of life (QoL) varied across the subgroups. The final mixture model included three subgroups of ACC-survivors: high symptoms (HS; n = 21), moderate symptoms (MS; n = 45), and low symptoms (LS; n = 34). ACC-survivors who reported at least one CHC were six times as likely to be classified in the HS subgroup as compared with the LS subgroup. Mean health-promoting lifestyle scores were lowest in the HS subgroup and highest in the LS subgroup. Differences in QoL among the subgroups were statistically significant, thus validating that the subgroups were characterized uniquely for identifying those symptoms with highest life impact. To our knowledge, we are the first to identify distinct subgroups of ACC-survivors differentiated by symptom cluster experience profiles. The findings warrant additional research to confirm the subgroup-specific symptom cluster experience profiles in larger studies of ACC-survivors.

AB - Although aggressive medical treatment protocols have led to 80% five-year survival rates for most childhood cancer patients, many long-term survivors experience multiple troubling symptoms. Using data from 100 adult survivors of childhood cancers (ACC-survivors), we used latent variable mixture modeling to generate unique subgroups of survivors based on their experiences with a cluster of eight symptoms: lack of energy, worry, pain, difficulty sleeping, feeling irritable, feeling nervous, difficulty concentrating, and feeling sad (as measured by the Memorial Symptom Assessment Scale). We also examined factors that were likely to predict subgroup membership (chronic health conditions [CHCs], health-promoting lifestyle, and demographic variables) and determined the extent to which satisfaction with quality of life (QoL) varied across the subgroups. The final mixture model included three subgroups of ACC-survivors: high symptoms (HS; n = 21), moderate symptoms (MS; n = 45), and low symptoms (LS; n = 34). ACC-survivors who reported at least one CHC were six times as likely to be classified in the HS subgroup as compared with the LS subgroup. Mean health-promoting lifestyle scores were lowest in the HS subgroup and highest in the LS subgroup. Differences in QoL among the subgroups were statistically significant, thus validating that the subgroups were characterized uniquely for identifying those symptoms with highest life impact. To our knowledge, we are the first to identify distinct subgroups of ACC-survivors differentiated by symptom cluster experience profiles. The findings warrant additional research to confirm the subgroup-specific symptom cluster experience profiles in larger studies of ACC-survivors.

KW - adult survivors of childhood cancers

KW - Cancer

KW - latent variable mixture models

KW - oncology

KW - quality of life

KW - symptom cluster

UR - http://www.scopus.com/inward/record.url?scp=67651151566&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67651151566&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2008.09.010

DO - 10.1016/j.jpainsymman.2008.09.010

M3 - Article

C2 - 19535218

AN - SCOPUS:67651151566

VL - 38

SP - 258

EP - 269

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 2

ER -