title: Variation in symptom distress in underserved Chinese American cancer patients.
abstract: BACKGROUND
  Cancer is prevalent in the rapidly growing Chinese American community, yet little is known about the symptom experience to guide comprehensive treatment planning. This study evaluated symptom prevalence and patient subgroups with symptom distress in a large sample of Chinese American cancer patients.
  
  
  METHODS
  Patients were consecutively recruited from 4 oncology practices, and they completed a translated cancer symptom scale. Latent class cluster analysis was used to identify subgroups of patients with distinct symptom distress profiles.
  
  
  RESULTS
  There were 1436 patients screened; 94.4% were non-English-speaking, and 45.1% were undergoing cancer therapy. The cancers included breast (32.6%), lung (14.8%), head and neck (12.5%), and hematologic cancer (10.1%). Overall, 1289 patients (89.8%) had 1 or more symptoms, and 1129 (78.6%) had 2 or more. The most prevalent symptoms were a lack of energy (57.0%), dry mouth (55.6%), feeling sad (49.3%), worrying (47.5%), and difficulty sleeping (46.8%). Symptoms causing "quite a bit" or "very much" distress included difficulty sleeping (37.9%), a lack of appetite (37.2%), feeling nervous (35.8%), pain (35.2%), and worrying (34.0%). Four patient subgroups were identified according to the probability of reporting moderate to high symptom distress: very low physical and psychological symptom distress (49.5%), low physical symptom distress and moderate psychological symptom distress (25.2%), moderate physical and psychological symptom distress (17.4%), and high physical and psychological symptom distress (7.8%).
  
  
  CONCLUSIONS
  Symptom prevalence is high in community-dwelling Chinese American cancer patients, and nearly half experience severe distress (rated as "quite a bit" or "very much" distressing) from physical symptoms, psychological symptoms, or both. These data have important implications for the development of effective symptom control interventions.
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York.
authors.forename: Lara K
authors.initials: LK
authors.lastname: Dhingra
authors.affiliation: Community Oncology Program, Asian Services Center, Mount Sinai Beth Israel, New York, New York.
authors.forename: Kin
authors.initials: K
authors.lastname: Lam
authors.affiliation: Community Private Practice, New York, New York.
authors.forename: William
authors.initials: W
authors.lastname: Cheung
authors.affiliation: Department of Medical Oncology, Mount Sinai Beth Israel Comprehensive Cancer Center, New York, New York.
authors.forename: Theresa
authors.initials: T
authors.lastname: Shao
authors.affiliation: Department of Medical Oncology, Mount Sinai Beth Israel Comprehensive Cancer Center, New York, New York.
authors.forename: Zujun
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Mount Sinai Beth Israel Comprehensive Cancer Center, New York, New York.
authors.forename: Sandra
authors.initials: S
authors.lastname: Van de Maele
authors.affiliation: Section of Hematology/Oncology, Veterans Affairs New Jersey Health Care System, East Orange, New Jersey.|Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey.
authors.forename: Victor T
authors.initials: VT
authors.lastname: Chang
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York.
authors.forename: Jack
authors.initials: J
authors.lastname: Chen
authors.affiliation: University of North New Jersey, Cranford, New Jersey.
authors.forename: Huiyan
authors.initials: H
authors.lastname: Ye
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York.
authors.forename: Rhoda
authors.initials: R
authors.lastname: Wong
authors.affiliation: Asian Services Center, Mount Sinai Beth Israel, New York, New York.|Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Wan Ling
authors.initials: WL
authors.lastname: Lam
authors.affiliation: Asian Services Center, Mount Sinai Beth Israel, New York, New York.
authors.forename: Selina
authors.initials: S
authors.lastname: Chan
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Bookbinder
authors.affiliation: School of Nursing, Department of Public Health and Preventative Medicine, Oregon Health and Science University, Portland, Oregon.|Decision Research, Eugene, Oregon.
authors.forename: Nathan F
authors.initials: NF
authors.lastname: Dieckmann
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York.|Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Russell
authors.initials: R
authors.lastname: Portenoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Condensed Memorial Symptom Assessment Scale; cancer disparities; ethnic Chinese; latent class cluster analysis (LCCA); minority health; symptom distress