title: Symptoms and Symptom Clusters Identified by Adolescents and Young Adults With Cancer Using a Symptom Heuristics App.
abstract: Adolescents and young adults (AYAs) with cancer experience multiple distressing symptoms during treatment. Because the typical approach to symptom assessment does not easily reflect the symptom experience of individuals, alternative approaches to enhancing communication between the patient and provider are needed. We developed an iPad-based application that uses a heuristic approach to explore AYAs' cancer symptom experiences. In this mixed-methods descriptive study, 72 AYAs (13-29 years old) with cancer receiving myelosuppressive chemotherapy used the Computerized Symptom Capture Tool (C-SCAT) to create images of the symptoms and symptom clusters they experienced from a list of 30 symptoms. They answered open-ended questions within the C-SCAT about the causes of their symptoms and symptom clusters. The images generated through the C-SCAT and accompanying free-text data were analyzed using descriptive, content, and visual analyses. Most participants (n = 70) reported multiple symptoms (M = 8.14). The most frequently reported symptoms were nausea (65.3%), feeling drowsy (55.6%), lack of appetite (55.6%), and lack of energy (55.6%). Forty-six grouped their symptoms into one or more clusters. The most common symptom cluster was nausea/eating problems/appetite problems. Nausea was most frequently named as the priority symptom in a cluster and as a cause of other symptoms. Although common threads were present in the symptoms experienced by AYAs, the graphic images revealed unique perspectives and a range of complexity of symptom relationships, clusters, and causes. Results highlight the need for a tailored approach to symptom management based on how the AYA with cancer perceives his or her symptom experience.
authors.affiliation: Associate Professor School of Nursing, Virginia Commonwealth University, 1100 East Leigh Street Richmond, VA, 23298.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Ameringer
authors.affiliation: Assistant Professor College of Nursing, University of Wisconsin-Milwaukee Milwaukee, WI.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Erickson
authors.affiliation: Staff Nurse Children's Hospital, Los Angeles, CA.
authors.forename: Catherine Fiona
authors.initials: CF
authors.lastname: Macpherson
authors.affiliation: Nurse Researcher Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Kristin
authors.initials: K
authors.lastname: Stegenga
authors.affiliation: Assistant Professor College of Nursing, University of Utah, Clinical Nurse Specialist, Primary Children's Hospital, Salt Lake City, UT.
authors.forename: Lauri A
authors.initials: LA
authors.lastname: Linder
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D034201:Computers, Handheld; D005221:Fatigue / Q000209:etiology; D005260:Female; D000066506:Heuristics; D006801:Humans; D008297:Male; D009325:Nausea / Q000209:etiology; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D063189:Symptom Assessment; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: adolescent; cancer; mobile technology; symptom assessment; symptom cluster; young adult