Symptoms, supportive care needs, and function in cancer patients: how are they related?

Abstract

Aims: To explore the associations among symptoms, supportive care needs, and function.

Methods: One hundred and seventeen cancer patients completed the Supportive Care Needs Survey and EORTC-QLQ-C30 in a cross-sectional study. Associations among function (physical, role, emotional, cognitive, social), symptoms (fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea), and supportive care needs (physical and daily living, psychological, patient care and support, health system and information, sexual) were tested using multivariate item regression (MIR). We tested (1) function as the dependent variable with symptoms and supportive care needs as independent variables and (2) supportive care needs as the dependent variable with symptoms and function as independent variables.

Results: Worse fatigue, pain, and appetite loss were associated with worse function. Greater unmet physical and daily living needs were associated with worse physical, role, and cognitive function. Greater unmet psychological needs were associated with worse emotional and cognitive function. Worse sleep problems were associated with greater unmet needs. Better physical function was associated with fewer unmet physical and daily living needs, and better emotional function was associated with fewer unmet psychological, patient care and support, and health system and information needs.

Conclusions: The results obtained with these models suggest several consistent relationships among symptoms, supportive care needs, and function.

Figure 1

Summary of relationships explored in multivariate item regression analyses. Solid lines illustrate relationships tested with Function as the outcome, and dashed lines illustrate relationships tested with Need as the outcome.

Figure 2a

Results of Function 2, Function 4a-4h, and Function 6 for the association between symptoms and functions. Triangles, circles, and Xs represent regression coefficients from linear regression models and vertical lines spanning them represent their 95% confidence intervals. Triangles indicate coefficients from Function 2, circles from Function 4a-4h, and Xs from Function 6. When there are two coefficients from one model within one symptom this indicates that an interaction was present and the appropriate functions to which the coefficient refers is noted above the plotting symbol.

Figure 2b

Results of Function 3, Function 5a-5e, and Function 6 for the association between needs and functions. Triangles, circles, and Xs represent regression coefficients from linear regression models and vertical lines spanning them represent their 95% confidence intervals. Triangles indicate coefficients from Function 3, circles from Function 5a-5e, and Xs from Function 6. When there are two coefficients from one model within one need this indicates that an interaction was present and the appropriate functions to which the coefficient refers is noted above the plotting symbol.

Figure 3a

Results of Need 2, Need 4a-4h, and Need 6 for the association between symptoms and needs. Triangles, circles, and Xs represent regression coefficients from linear regression models and vertical lines spanning them represent their 95% confidence intervals. Triangles indicate coefficients from Need 2, circles from Need 4a-4h, and Xs from Need 6. When there are two coefficients from one model within one symptom this indicates that an interaction was present and the appropriate needs to which the coefficient refers is noted above the plotting symbol.

Figure 3b

Results of Need 3, Need 5a-5e, and Need 6 for the association between functions and needs. Triangles, circles, and Xs represent regression coefficients from linear regression models and vertical lines spanning them represent their 95% confidence intervals. Triangles indicate coefficients from Function 3, circles from Need 5a-5e, and Xs from Need 6. When there are two coefficients from one model within one function this indicates that an interaction was present and the appropriate needs to which the coefficient refers is noted above the plotting symbol.