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Variations in Symptom Severity Patterns Among Oropharyngeal and Laryngeal Cancer Outpatients During Radiation
Mary Ellen Haisfield-Wolfe1, Carl Brown, Marian Richardson
1Author Affiliations: School of Medicine, University of Maryland, Baltimore (Dr Haisfield-Wolfe); Oregon Nurses Association, Tualatin (Dr Brown); and Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Hospital (Dr Richardson); and Department of Otolaryngology, Head & Neck Surgery, Johns Hopkins University (MsWebster), Baltimore, Maryland.
Background:
Pain, difficulty swallowing, dry mouth, taste change, appetite loss, and mouth sores are associated with radiotherapy (RT). Knowledge of individual symptom patterns (ISPs) and differences among patients during RT can provide vital information for evaluation and delivery of patient-tailored care.
Objective:
The objectives of this study were to identify and describe ISPs and symptom duration, resolution, and peak severity among outpatients with oropharyngeal and laryngeal cancer.
Methods:
This was an analysis of data from a larger study using Visual Graphical Analysis to examine 21 outpatients' ISPs over RT. Individual symptom patterns for 6 severe symptoms were grouped by ISP and evaluated by a panel of experts.
Results:
Three types of ISPs were identified. The majority of patients displayed a problematic ISP type for pain and difficulty swallowing. When the ISPs of a patient's 6 symptoms were displayed together, the presence of several ISP types was noted. A majority experienced at least 1 symptom pattern that was problematic, indicating the uniqueness of each patient's symptom experience.
Conclusions:
During cancer treatment, patients experience multiple symptoms that change in severity over a course of care. Visualizing the patterns of patient-reported symptoms provided information regarding 6 severe symptoms experienced by patients.
Implications For Practice:
Identifying ISPs provided information about symptom variations among patients with oropharyngeal and laryngeal cancer, which can influence symptom management strategies used by providers. Study techniques used can be useful for nurses when managing patients' symptoms. In the future, information using real-time data visualized as patterns could be used to manage multiple symptoms experienced by patients during treatment.
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