Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy
Cancer and its treatment are inherently stressful and stress impacts important patient outcomes. Patients vary considerably in their response to stress. Understanding this variability requires a patient-centered multidimensional approach. The objectives of this study were to identify and characteriz...
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| Veröffentlicht in: | Journal of pain and symptom management 2020-03, Vol.59 (3), p.646-657 |
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| container_title | Journal of pain and symptom management |
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| creator | Langford, Dale J. Cooper, Bruce Paul, Steven Humphreys, Janice Hammer, Marilyn J. Levine, Jon Conley, Yvette P. Wright, Fay Dunn, Laura B. Miaskowski, Christine |
| description | Cancer and its treatment are inherently stressful and stress impacts important patient outcomes. Patients vary considerably in their response to stress. Understanding this variability requires a patient-centered multidimensional approach.
The objectives of this study were to identify and characterize patient subgroups with distinct multidimensional stress profiles (stress appraisal, exposure, and adaptation) during cancer treatment.
Among 957 patients undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer, latent profile analysis was performed to identify patient subgroups using concurrent evaluations of global (Perceived Stress Scale) and cancer-specific (Impact of Events Scale–Revised) stress, lifetime stress exposure (Life Stressor Checklist–Revised), and resilience (Connor-Davidson Resilience Scale-10).
Three latent classes were identified: “Normative” (54.3%; intermediate global stress and resilience, lower cancer-related stress, lowest life stress); “Stressed” (39.9%; highest global and cancer-specific stress scores, lowest resilience, most life stress); and “Resilient” (5.7%; lowest global stress, cancer-specific stress comparable to Normative class, highest resilience, intermediate life stress). Characteristics that distinguished the Stressed from the Normative class included the following: younger age, female gender, lower socioeconomic status, unmarried/partnered, living alone, poorer functional status, and higher comorbidity burden. Compared to Stressed patients, Resilient patients were more likely to be partnered, to not live alone, and had a higher functional status. No demographic or clinical characteristics differentiated Normative from Resilient patients. Exposure to specific life stressors differed significantly among the classes.
A subset of patients warrants intensive psychosocial intervention to reduce stress and improve adaptation to cancer. Intervention efforts may be informed by further study of Resilient patients. |
| doi_str_mv | 10.1016/j.jpainsymman.2019.10.025 |
| format | Article |
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The objectives of this study were to identify and characterize patient subgroups with distinct multidimensional stress profiles (stress appraisal, exposure, and adaptation) during cancer treatment.
Among 957 patients undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer, latent profile analysis was performed to identify patient subgroups using concurrent evaluations of global (Perceived Stress Scale) and cancer-specific (Impact of Events Scale–Revised) stress, lifetime stress exposure (Life Stressor Checklist–Revised), and resilience (Connor-Davidson Resilience Scale-10).
Three latent classes were identified: “Normative” (54.3%; intermediate global stress and resilience, lower cancer-related stress, lowest life stress); “Stressed” (39.9%; highest global and cancer-specific stress scores, lowest resilience, most life stress); and “Resilient” (5.7%; lowest global stress, cancer-specific stress comparable to Normative class, highest resilience, intermediate life stress). Characteristics that distinguished the Stressed from the Normative class included the following: younger age, female gender, lower socioeconomic status, unmarried/partnered, living alone, poorer functional status, and higher comorbidity burden. Compared to Stressed patients, Resilient patients were more likely to be partnered, to not live alone, and had a higher functional status. No demographic or clinical characteristics differentiated Normative from Resilient patients. Exposure to specific life stressors differed significantly among the classes.
A subset of patients warrants intensive psychosocial intervention to reduce stress and improve adaptation to cancer. Intervention efforts may be informed by further study of Resilient patients.</description><identifier>ISSN: 0885-3924</identifier><identifier>EISSN: 1873-6513</identifier><identifier>DOI: 10.1016/j.jpainsymman.2019.10.025</identifier><identifier>PMID: 31711968</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adaptation ; Breast cancer ; Cancer ; Chemotherapy ; Clinical outcomes ; Comorbidity ; Demography ; Functional status ; Intensive treatment ; latent profile analysis ; Life stress ; Living alone ; Lung cancer ; Mental health ; Multidimensional approach ; Oncology ; Patient-centered care ; Patients ; Psychosocial factors ; Psychosocial intervention ; Resilience ; Socioeconomic status ; Stress ; Stress management ; Variability</subject><ispartof>Journal of pain and symptom management, 2020-03, Vol.59 (3), p.646-657</ispartof><rights>2019 American Academy of Hospice and Palliative Medicine</rights><rights>Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Mar 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-8058851ccadab29738febb3218ffa679fa790f3a866e7dc0658dda656564ddb33</citedby><cites>FETCH-LOGICAL-c456t-8058851ccadab29738febb3218ffa679fa790f3a866e7dc0658dda656564ddb33</cites><orcidid>0000-0003-3061-5252 ; 0000-0001-8932-4113</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0885392419306426$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,30978,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31711968$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Langford, Dale J.</creatorcontrib><creatorcontrib>Cooper, Bruce</creatorcontrib><creatorcontrib>Paul, Steven</creatorcontrib><creatorcontrib>Humphreys, Janice</creatorcontrib><creatorcontrib>Hammer, Marilyn J.</creatorcontrib><creatorcontrib>Levine, Jon</creatorcontrib><creatorcontrib>Conley, Yvette P.</creatorcontrib><creatorcontrib>Wright, Fay</creatorcontrib><creatorcontrib>Dunn, Laura B.</creatorcontrib><creatorcontrib>Miaskowski, Christine</creatorcontrib><title>Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy</title><title>Journal of pain and symptom management</title><addtitle>J Pain Symptom Manage</addtitle><description>Cancer and its treatment are inherently stressful and stress impacts important patient outcomes. Patients vary considerably in their response to stress. Understanding this variability requires a patient-centered multidimensional approach.
The objectives of this study were to identify and characterize patient subgroups with distinct multidimensional stress profiles (stress appraisal, exposure, and adaptation) during cancer treatment.
Among 957 patients undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer, latent profile analysis was performed to identify patient subgroups using concurrent evaluations of global (Perceived Stress Scale) and cancer-specific (Impact of Events Scale–Revised) stress, lifetime stress exposure (Life Stressor Checklist–Revised), and resilience (Connor-Davidson Resilience Scale-10).
Three latent classes were identified: “Normative” (54.3%; intermediate global stress and resilience, lower cancer-related stress, lowest life stress); “Stressed” (39.9%; highest global and cancer-specific stress scores, lowest resilience, most life stress); and “Resilient” (5.7%; lowest global stress, cancer-specific stress comparable to Normative class, highest resilience, intermediate life stress). Characteristics that distinguished the Stressed from the Normative class included the following: younger age, female gender, lower socioeconomic status, unmarried/partnered, living alone, poorer functional status, and higher comorbidity burden. Compared to Stressed patients, Resilient patients were more likely to be partnered, to not live alone, and had a higher functional status. No demographic or clinical characteristics differentiated Normative from Resilient patients. Exposure to specific life stressors differed significantly among the classes.
A subset of patients warrants intensive psychosocial intervention to reduce stress and improve adaptation to cancer. Intervention efforts may be informed by further study of Resilient patients.</description><subject>Adaptation</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Demography</subject><subject>Functional status</subject><subject>Intensive treatment</subject><subject>latent profile analysis</subject><subject>Life stress</subject><subject>Living alone</subject><subject>Lung cancer</subject><subject>Mental health</subject><subject>Multidimensional approach</subject><subject>Oncology</subject><subject>Patient-centered care</subject><subject>Patients</subject><subject>Psychosocial factors</subject><subject>Psychosocial intervention</subject><subject>Resilience</subject><subject>Socioeconomic status</subject><subject>Stress</subject><subject>Stress management</subject><subject>Variability</subject><issn>0885-3924</issn><issn>1873-6513</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqNkEtrGzEQgEVISNykf6FsyaWXdaSV9dhjcB8pBGJIfBZaadbRsiu5khzwv6-M3VJ6CnMYmPnmwYfQZ4LnBBN-N8yHrXY-7adJ-3mDSVvqc9ywMzQjUtCaM0LP0QxLyWraNosr9CGlAWPMKKeX6IoSQUjL5Qw9fHUpO29y9ZwjpFStYujdCKm6n4LfVE_ehDFs9tVKZwc-p2rtLcRNcKW5fIUp5FeIeru_QRe9HhN8POVrtP7-7WX5UD8-_fi5vH-szYLxXEvMylPEGG1117SCyh66jjZE9r3mou21aHFPteQchDWYM2mt5qzEwtqO0mv05bh3G8OvHaSsJpcMjKP2EHZJNZQscEOFlAW9_Q8dwi768l2hBBGcc8oK1R4pE0NKEXq1jW7Sca8IVgfdalD_6FYH3YdW0V1mP50u7LoJ7N_JP34LsDwCUJS8OYgqmaLRgHURTFY2uHec-Q0cnpdc</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Langford, Dale J.</creator><creator>Cooper, Bruce</creator><creator>Paul, Steven</creator><creator>Humphreys, Janice</creator><creator>Hammer, Marilyn J.</creator><creator>Levine, Jon</creator><creator>Conley, Yvette P.</creator><creator>Wright, Fay</creator><creator>Dunn, Laura B.</creator><creator>Miaskowski, Christine</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3061-5252</orcidid><orcidid>https://orcid.org/0000-0001-8932-4113</orcidid></search><sort><creationdate>202003</creationdate><title>Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy</title><author>Langford, Dale J. ; Cooper, Bruce ; Paul, Steven ; Humphreys, Janice ; Hammer, Marilyn J. ; Levine, Jon ; Conley, Yvette P. ; Wright, Fay ; Dunn, Laura B. ; Miaskowski, Christine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-8058851ccadab29738febb3218ffa679fa790f3a866e7dc0658dda656564ddb33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adaptation</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Demography</topic><topic>Functional status</topic><topic>Intensive treatment</topic><topic>latent profile analysis</topic><topic>Life stress</topic><topic>Living alone</topic><topic>Lung cancer</topic><topic>Mental health</topic><topic>Multidimensional approach</topic><topic>Oncology</topic><topic>Patient-centered care</topic><topic>Patients</topic><topic>Psychosocial factors</topic><topic>Psychosocial intervention</topic><topic>Resilience</topic><topic>Socioeconomic status</topic><topic>Stress</topic><topic>Stress management</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Langford, Dale J.</creatorcontrib><creatorcontrib>Cooper, Bruce</creatorcontrib><creatorcontrib>Paul, Steven</creatorcontrib><creatorcontrib>Humphreys, Janice</creatorcontrib><creatorcontrib>Hammer, Marilyn J.</creatorcontrib><creatorcontrib>Levine, Jon</creatorcontrib><creatorcontrib>Conley, Yvette P.</creatorcontrib><creatorcontrib>Wright, Fay</creatorcontrib><creatorcontrib>Dunn, Laura B.</creatorcontrib><creatorcontrib>Miaskowski, Christine</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pain and symptom management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langford, Dale J.</au><au>Cooper, Bruce</au><au>Paul, Steven</au><au>Humphreys, Janice</au><au>Hammer, Marilyn J.</au><au>Levine, Jon</au><au>Conley, Yvette P.</au><au>Wright, Fay</au><au>Dunn, Laura B.</au><au>Miaskowski, Christine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy</atitle><jtitle>Journal of pain and symptom management</jtitle><addtitle>J Pain Symptom Manage</addtitle><date>2020-03</date><risdate>2020</risdate><volume>59</volume><issue>3</issue><spage>646</spage><epage>657</epage><pages>646-657</pages><issn>0885-3924</issn><eissn>1873-6513</eissn><abstract>Cancer and its treatment are inherently stressful and stress impacts important patient outcomes. Patients vary considerably in their response to stress. Understanding this variability requires a patient-centered multidimensional approach.
The objectives of this study were to identify and characterize patient subgroups with distinct multidimensional stress profiles (stress appraisal, exposure, and adaptation) during cancer treatment.
Among 957 patients undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer, latent profile analysis was performed to identify patient subgroups using concurrent evaluations of global (Perceived Stress Scale) and cancer-specific (Impact of Events Scale–Revised) stress, lifetime stress exposure (Life Stressor Checklist–Revised), and resilience (Connor-Davidson Resilience Scale-10).
Three latent classes were identified: “Normative” (54.3%; intermediate global stress and resilience, lower cancer-related stress, lowest life stress); “Stressed” (39.9%; highest global and cancer-specific stress scores, lowest resilience, most life stress); and “Resilient” (5.7%; lowest global stress, cancer-specific stress comparable to Normative class, highest resilience, intermediate life stress). Characteristics that distinguished the Stressed from the Normative class included the following: younger age, female gender, lower socioeconomic status, unmarried/partnered, living alone, poorer functional status, and higher comorbidity burden. Compared to Stressed patients, Resilient patients were more likely to be partnered, to not live alone, and had a higher functional status. No demographic or clinical characteristics differentiated Normative from Resilient patients. Exposure to specific life stressors differed significantly among the classes.
A subset of patients warrants intensive psychosocial intervention to reduce stress and improve adaptation to cancer. Intervention efforts may be informed by further study of Resilient patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31711968</pmid><doi>10.1016/j.jpainsymman.2019.10.025</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-3061-5252</orcidid><orcidid>https://orcid.org/0000-0001-8932-4113</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Elsevier ScienceDirect Journals |
| subjects | Adaptation Breast cancer Cancer Chemotherapy Clinical outcomes Comorbidity Demography Functional status Intensive treatment latent profile analysis Life stress Living alone Lung cancer Mental health Multidimensional approach Oncology Patient-centered care Patients Psychosocial factors Psychosocial intervention Resilience Socioeconomic status Stress Stress management Variability |
| title | Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy |
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