Symptom distress in older adults following cancer surgery

Janet Van Cleave, Brian L. Egleston, Elizabeth Ercolano, Ruth McCorkle

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. OBJECTIVE:: We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. METHODS:: This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. RESULTS:: A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P < .001, 6 months: P = .002) than at baseline while controlling for demographic, biologic, psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P < .05). Participants 75 years or older reported increased symptom distress over time compared with those aged 65 to 69 years (P < .05). CONCLUSIONS:: Age, type of cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. IMPLICATIONS FOR PRACTICE:: Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

Original languageEnglish (US)
Pages (from-to)292-300
Number of pages9
JournalCancer Nursing
Volume36
Issue number4
DOIs
StatePublished - Jul 2013

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Thorax
Comorbidity
Neoplasms
Mental Health
Urogenital Neoplasms
Pelvic Neoplasms
Time Management
Morbidity
New England
Nurses
Demography
Clinical Trials
Psychology
Health
Therapeutics

Keywords

  • Cancer
  • Older
  • Surgery
  • Symptom distress

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

Cite this

Symptom distress in older adults following cancer surgery. / Van Cleave, Janet; Egleston, Brian L.; Ercolano, Elizabeth; McCorkle, Ruth.

In: Cancer Nursing, Vol. 36, No. 4, 07.2013, p. 292-300.

Research output: Contribution to journalArticle

Van Cleave, Janet ; Egleston, Brian L. ; Ercolano, Elizabeth ; McCorkle, Ruth. / Symptom distress in older adults following cancer surgery. In: Cancer Nursing. 2013 ; Vol. 36, No. 4. pp. 292-300.
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AB - BACKGROUND:: Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. OBJECTIVE:: We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. METHODS:: This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. RESULTS:: A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P < .001, 6 months: P = .002) than at baseline while controlling for demographic, biologic, psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P < .05). Participants 75 years or older reported increased symptom distress over time compared with those aged 65 to 69 years (P < .05). CONCLUSIONS:: Age, type of cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. IMPLICATIONS FOR PRACTICE:: Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

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