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Open Access Publications from the University of California

Scholarly Works (2 results)

  • Thesis
  • Peer Reviewed
UC San Francisco Electronic Theses and Dissertations (2011)

Many people with advanced cancer experience multiple severe symptoms as their disease progresses such as pain, sleep problems, fatigue, and depression. These symptoms can be a result of the cancer itself, cancer treatment or an interaction of the two. The studies reported in this dissertation uses the patients' own responses to survey questions to describe the multiple dimensions of the symptom experience; the factors that predict the total number of symptoms; as well as the optimal cutpoint between a low and a high number of symptoms and the between group differences in patient outcomes (i.e., depression, anxiety, quality-of-life).

At this time, very little is known about the cause or impact of multiple symptoms in patients with advanced cancer. The findings from this research have the potential to improve our understanding of the multiple dimensions of the symptom experience in patients with advanced cancer. Specifically, this work may facilitate the identification of symptoms that share a common biological mechanism. In addition, this research has the potential to lead to the identification of patients who are at higher risk for different symptom experiences and who require different symptom management interventions.

    Cover page: Multiple Dimensions of the Symptom Experience in Patients with Advanced Cancer and their Impact on Quality of Life
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2012)
    While patients with advanced cancer experience a wide range of symptoms, no work has been done to determine an optimal cutpoint for a low versus a high number of symptoms. Analytic approaches that established clinically meaningful cutpoints for the severity of cancer pain and fatigue provided the foundation for this study. The purpose of this study was to determine the optimal cutpoint for low and high numbers of symptoms using a range of potential cutpoints and to determine if those cutpoints distinguished between the two symptom groups on demographic and clinical characteristics and depression, anxiety, and quality of life (QOL). Patients with advanced cancer (n=110) completed a symptom assessment scale, and measures of depression, anxiety, and QOL. Combinations of cutpoints were tested to yield one- and two-cutpoint solutions. Using analysis of variance for QOL scores, the F-ratio that indicated the highest between-group difference was determined to be the optimal cutpoint between low and high number of symptoms. A cutpoint of ≤ 12 symptoms (i.e., 0-12 is low, 13-32 is high) was the optimal cutpoint for total number of symptoms. Significant differences in depression, anxiety, and QOL scores validated this cutpoint. Psychological symptoms had higher occurrence rates in the high symptom group. Findings suggest that a threshold exists between a low and a high number of symptoms in patients with advanced cancer. Psychological symptoms were significantly different between patients in the low versus high symptom groups and may play an important role in QOL outcomes in patients with advanced cancer.
      Cover page: Determination of cutpoints for low and high number of symptoms in patients with advanced cancer.
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