The specific aims of the proposed pilot research are to: 1) systematically examine the relationships between and among a group of physical symptoms (fatigue, insomnia, pain, and nausea/vomiting) typically experienced during cancer chemotherapy to determine whether or not they form one or more clusters; and, 2) test alternative models of the impact of these symptoms (and/or symptom clusters) on psychological and functional well-being. The overall goal of this research is to generate hypotheses for future research about the characteristics and effects of symptom clusters during cancer treatment. Indicators of a symptom cluster include two or more symptoms with a common predictor (or cause), pattern, or effect on another symptom(s). A longitudinal descriptive design will be used to examine symptoms and quality of life during one cycle of chemotherapy. Measures will be taken at three data points: 1) day 1 of cycle prior to receiving chemotherapy; 2) day 4 of cycle; 3) last day of cycle. Administering measures at these data points will allow us to track the pattern of symptoms from baseline before treatment to a known symptom high point (day 4) for fatigue, insomnia, and delayed nausea/vomiting to a known symptom low point (last day). The use of repeated measures will enable us to examine symptom patterns as well as temporal patterns by which symptoms could influence other symptoms over time. This design also will allow us to examine relationships between symptoms and other quality of life dimensions at each data point as well as changes over time.
For aim #1, five research questions will be examined independently using correlation, multiple regressions, and/or repeated measures ANOVA. The result of each analysis will provide one indication of the presence or absence of a symptom cluster. The number of indicators and the nature of the relationships described will be used to decide whether or not the symptoms under investigation form a cluster.
For aim #2, two hypotheses will be examined using multiple regression techniques to test whether functional well-being is a mediator between individual symptoms (or symptom clusters) and psychological well-being.
| Barsevick, Andrea M; Dudley, William N; Beck, Susan L (2006) Cancer-related fatigue, depressive symptoms, and functional status: a mediation model. Nurs Res 55:366-72 |
