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Support Care Cancer. 2018 Nov;26(11):3781-3788. doi: 10.1007/s00520-018-4244-8. Epub 2018 May 7.

Metastatic breast cancer patients' expectations and priorities for symptom improvement.

Author information

1
Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA. dbtometi@iupui.edu.
2
Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
3
Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA.
4
Center for Health Services Research, Regenstrief Institute, 1101 W 10th St, Indianapolis, IN, 46202, USA.
5
VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, 1481 W 10th St, Indianapolis, IN, 46202, USA.
6
Department of Communication Studies, Indiana University-Purdue University Indianapolis, 425 University Blvd, Indianapolis, IN, 46202, USA.
7
Department of Psychiatry, Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA.
8
Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Dr, Indianapolis, IN, 46202, USA.
9
Banner MD Anderson Cancer Center, 2946 E Banner Gateway Dr, Gilbert, AZ, 85234, USA.

Abstract

PURPOSE:

Little research has examined cancer patients' expectations, goals, and priorities for symptom improvement. Thus, we examined these outcomes in metastatic breast cancer patients to provide patients' perspectives on clinically meaningful symptom improvement and priorities for symptom management.

METHODS:

Eighty women with metastatic breast cancer participated in a survey with measures of comorbidity, functional status, engagement in roles and activities, distress, quality of life, and the modified Patient-Centered Outcomes Questionnaire that focused on 10 common symptoms in cancer patients.

RESULTS:

On average, patients reported low to moderate severity across the 10 symptoms and expected symptom treatment to be successful. Patients indicated that a 49% reduction in fatigue, 48% reduction in thinking problems, and 43% reduction in sleep problems would represent successful symptom treatment. Cluster analysis based on ratings of the importance of symptom improvement yielded three clusters of patients: (1) those who rated thinking problems, sleep problems, and fatigue as highly important, (2) those who rated pain as moderately important, and (3) those who rated all symptoms as highly important. The first patient cluster differed from other subgroups in severity of thinking problems and education.

CONCLUSIONS:

Metastatic breast cancer patients report differing symptom treatment priorities and criteria for treatment success across symptoms. Considering cancer patients' perspectives on clinically meaningful symptom improvement and priorities for symptom management will ensure that treatment is consistent with their values and goals.

KEYWORDS:

Expectation; Metastatic breast cancer; Patient-centered; Priorities; Symptom; Treatment outcome

PMID:
29736866
PMCID:
PMC6221997
[Available on 2019-11-01]
DOI:
10.1007/s00520-018-4244-8

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