Predictors of patterns of pain, fatigue, and insomnia during the first year after a cancer diagnosis in the elderly.
Pain (P), fatigue (F), and insomnia (I) are among the most prevalent, distressing, and undermanaged symptoms experienced by cancer patients. Research has demonstrated that PFI co-occur; what remain unclear are the patterns and stability of PFI and the patient, disease, and treatment characteristics that predict PFI patterns over time. This secondary analysis used a data set composed of 867 elders (46% women) who were newly diagnosed with breast, colorectal, lung, or prostate cancer and followed at 4 points during the year after diagnosis. The university's institutional review board approved this study. Descriptive statistics and multistate transition models using multinomial logistic regression were used. The typical participant was 72.6 years old, who reported 7.9 symptoms and 2.7 comorbidities. Previous PFI pattern was consistently associated with significantly increased risks of subsequent PFI pattern. At observations 1 to 3, lung cancer, treatment, higher comorbidity with breast cancer, and late-stage colorectal cancer were significantly associated with increased risks of PFI patterns. Advancing age was not significantly associated with increased risks of PFI patterns. Pain, fatigue, and insomnia co-occurrence declined over time but was associated with significantly increased risks of death or loss to follow-up and increased reports of other symptoms. Pain, fatigue, and insomnia co-occurrence is associated with adverse outcomes and should be proactively targeted for intervention.
Kozachik
Sharon L
SL
School of Nursing, Johns Hopkins University, Baltimore, Maryland 21205, USA. skozach1@son.jhmi.edu
Bandeen-Roche
Karen
K
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D007196:Indiana / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D011581:Psychological Tests; D011594:Psychometrics; D012307:Risk Factors; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013997:Time Factors
Neuroimmunomodulation. 2004;11(5):279-92
15316238
J Clin Oncol. 2000 Feb;18(4):743-53
10673515
Cancer. 2003 Jun 1;97(11):2919-25
12767108
Support Care Cancer. 2006 May;14(5):444-53
16402231
Clin Geriatr Med. 2001 Aug;17(3):417-31, v
11459713
J Pain Symptom Manage. 1999 May;17(5):320-32
10355211
J Pain Symptom Manage. 1994 Aug;9(6):372-82
7963790
Oncol Nurs Forum. 2000 Oct;27(9):1443-8
11058976
Med Care. 2000 May;38(5):482-93
10800975
Heart Lung. 1997 Jan-Feb;26(1):23-30
9013218
Cancer Nurs. 1978 Oct;1(5):373-8
250445
Soc Sci Med. 2002 May;54(9):1309-21
12058848
Sleep Med Rev. 2006 Oct;10(5):357-69
16386930
J Pain Symptom Manage. 1999 Jun;17(6):402-9
10388245
Oncol Nurs Forum. 2005 May 10;32(3):542
15897927
Semin Neurol. 2005 Mar;25(1):106-16
15798943
Qual Life Res. 1994 Jun;3(3):183-9
7920492
Cancer Pract. 1996 Jul-Aug;4(4):185-90
8900759
Med Care. 1996 Jan;34(1):73-84
8551813
Nurs Res. 2001 Jul-Aug;50(4):222-32
11480531
J Pain Symptom Manage. 1995 Aug;10(6):423-31
7561224
J Pain Symptom Manage. 2004 Sep;28(3):225-32
15336334
CA Cancer J Clin. 2001 Nov-Dec;51(6):329-36
11760567
Oncol Nurs Forum. 2001 Apr;28(3):465-70
11338755
Cancer Pract. 1999 May-Jun;7(3):136-44
10352076
Sleep. 2007 Sep;30(9):1145-52
17910386
Palliat Support Care. 2005 Mar;3(1):23-31
16594191
J Pain Symptom Manage. 2003 Apr;25(4):307-18
12691682
Bone Marrow Transplant. 2001 Sep;28(5):503-9
11593325
J Pain Symptom Manage. 1996 Oct;12(4):221-8
8898505
J Pain Symptom Manage. 2003 Jan;25(1):9-18
12565184
J Pain Symptom Manage. 2001 Jun;21(6):456-66
11397603
Pain. 2001 Sep;93(3):247-257
11514084
J Pain Symptom Manage. 1996 Jun;11(6):370-7
8935141
Oncol Nurs Forum. 2007 Jul;34(4):785-92
17723980