The Effect of the Pain Symptom Cluster on Performance in Women Diagnosed with Advanced Breast Cancer: The Mediating Role of the Psychoneurological Symptom Cluster |
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| Institution: | 1. From the Nursing Department, Indiana University-Fort Wayne (IUFW), Fort Wayne, IN, USA;2. College of Nursing, Kent State University, Kent, OH, USA;3. Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA;4. The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA;5. Faculty of Health Sciences, Trinity College, Dublin 2, Ireland;6. Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, OH, USA;1. College of Nursing, Washington State University, Spokane, Washington;2. Program of Excellence in Addictions Research, Washington State University, Spokane, Washington;3. Translational Addiction Research Center, Washington State University, Spokane, Washington;4. College of Nursing, University of Missouri St. Louis, St. Louis, Missouri;6. College of Medicine, Washington State University, Spokane, Washington;1. Mu?la S?tk? Koçman University, Fethiye Vocational School of Health Services, Elderly Care Program, Mu?la, Turkey;2. Ege University, Nursing Faculty, Department of Fundamental Nursing, Izmir, Turkey;1. New Hanover Regional Medical Center, Wilmington, NC;2. Nurse Practitioner, Section of Palliative Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH;3. Pain Management, CHI Franciscan Health, Tacoma, WA;1. Ingram School of Nursing, McGill University, Montréal, Québec, Canada;2. Hôpital du Sacré-C?ur de Montréal, Montréal, Québec, Canada;3. Centre for Nursing Research, Jewish General Hospital, Montréal, Québec, Canada;4. College of Nursing, Florida State University, Tallahassee, Florida;6. Faculté des Sciences Infirmières, Université de Montréal and Centre de Recherche, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada;5. Department of Anesthesiology, Université de Montréal, Centre de Recherche, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada;1. University of Manchester, Manchester, UK;2. Manchester University NHS Foundation Trust, Manchester, UK |
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| Abstract: | Background: Pain, depression, anxiety, sleep disturbances, and constipation were reported in different symptom clusters at different stages of breast cancer. Managing symptom clusters rather than individual symptoms can improve performance status. Aim: The study examined the effect of pain symptom cluster (pain and constipation) on performance when mediated by the psychoneurological symptom cluster (depression, anxiety, and sleep disturbances) using age as a moderator. Design: A secondary analysis. Settings: Palliative care center at a tertiary medical center in northeast Ohio. Participants: Eighty-six women diagnosed with advanced breast cancer. Method: A quantitative cross-sectional approach. Results: Ordinal logistic regression showed that pain symptom cluster did not have a significant mediation effect on performance. Odds ratio indicated that subjects with pain symptom cluster were 63% more likely to be bedridden (odds ratio = 1.63, confidence interval = .69-3.84). Women who reported pain symptom cluster were 5% more likely to have psychoneurological symptom cluster (odds ratio = 1.05, confidence interval = .400-2.774). Stratified analysis of age showed no differences in performance. Post-hoc analysis showed that the components of pain symptom cluster had a significant effect on psychoneurological symptom cluster (odds ratio: 3 1.18-7.62]). Conclusions: Pain, constipation, depression, anxiety, and sleep disturbances were highly prevalent in women with advanced breast cancer. However, they tended to cluster in different symptom clusters. Although some findings were not significant, they all supported the direction of the tested hypotheses. Variations in symptom clusters research, including methodology, instruments, statistical tests, and chosen symptom cluster correlation coefficient, should be addressed. |
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