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Symptom perception and functioning in patients with advanced cancer
Eun Joo Yang1, Keun Seok Lee2, Myong Cheol Lim3
1Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Plos One
|February 4, 2021
Summary
Symptom perception in advanced cancer patients impacts functioning. Somatic sensations directly affect function, while experienced symptoms indirectly influence somatic sensations, not disability directly.
Area of Science:
- Oncology
- Rehabilitation Medicine
- Psychosomatic Medicine
Background:
- Symptom perception significantly influences patient quality of life and functional status in advanced cancer.
- Understanding the complex interplay between different dimensions of symptom perception is crucial for effective patient management.
- Existing models may not fully capture the nuanced relationship between how patients perceive symptoms and their resulting disability.
Purpose of the Study:
- To investigate the relationship between symptom perception, specifically somatic sensation and experienced symptoms, and functional impairment in advanced cancer patients.
- To develop and validate a structural model that elucidates how different aspects of symptom perception influence patient functioning.
- To differentiate the impact of direct somatic sensations versus overall experienced symptoms on disability.
Main Methods:
- A cross-sectional observational study involving 459 patients with advanced cancer.
- Assessment of functioning using the World Health Organization Disability Assessment Schedule II (WHODAS II).
- Evaluation of symptoms via the Memorial Symptom Assessment Scale-Short Form, followed by confirmatory factor analysis to model symptom perception.
Main Results:
- A significant direct pathway was identified between somatic sensation and disability (β = 16.11, p < 0.001).
- Experienced symptoms significantly influenced somatic sensations (β = 0.717, p < 0.001) but showed no direct association with disability.
- A complex structural model incorporating first-order (somatic sensation) and second-order (experienced symptoms) factors demonstrated an excellent fit (CFI/TLI > 0.950).
Conclusions:
- The relationship between symptom perception and functioning in advanced cancer differs between somatic sensations and experienced symptoms.
- Symptom structure is best understood as direct somatic sensation and indirect experienced symptoms.
- Improved understanding of symptom perception is vital for developing targeted rehabilitation strategies for advanced cancer patients.
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