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Published on: March 6, 2018
Transitions in Symptom Cluster Subgroups Among Men Undergoing Prostate Cancer Radiation Therapy
Shannon Ruff Dirksen1, Michael J Belyea, William Wong
1Author Affiliations: College of Nursing and Health Innovation, Arizona State University, Phoenix (Drs Dirksen and Belyea); Mayo Clinic, Scottsdale (Dr Wong); Phoenix Veterans Affairs Health Care System, Phoenix, Arizona (Dr Epstein).
Background:
Prostate cancer is a common type of cancer worldwide and in the United States. However, little information has been reported on the symptoms of men over time who receive radiation therapy.
Objective:
The objectives of this study were to identify subgroups of men at pre- and post-radiation therapy on general and treatment-related symptoms and to determine transitions in subgroup membership over time.
Methods:
Men (n = 84) receiving radiation therapy completed questionnaires on fatigue, insomnia, pain, depression, anxiety, and sexual, urinary, and bowel problems at pretreatment and posttreatment. Latent class analysis identified subgroups. One-way analyses of variance determined subgroups differed on symptoms, participant characteristics, and quality of life. Latent transition analysis examined subgroup transitions over time.
Results:
At pretreatment, 4 subgroups were identified: resilient group, with little to no symptom reporting; adjusted group, with moderately high treatment-related symptoms, low insomnia, depression, and anxiety; distressed group, consistently high on most symptoms; and emerging group, with moderately high fatigue, depression, and anxiety with few treatment-related symptoms. At posttreatment, similar results were seen in groups to those at pretreatment: resilient, adjusted. and distressed groups with an impacted group having high pain, insomnia, depression, and urinary and bowel symptoms. Quality of life and participant characteristics further distinguished groups at pretreatment and posttreatment. Income level predicted a transition in group membership.
Conclusions:
Men can be classified into distinctly different subgroups over time.
Implications For Practice:
Assessment and intervention with men in subgroups such as distressed and emerging before and during treatment may lessen potential for remaining distressed or moving into impacted group where symptom severity is high at posttreatment. Interventions to reduce multiple symptoms are vitally needed.
