Pilot Study to Describe the Trajectory of Symptoms and Adaptive Strategies of Adults Living with Low-grade Glioma

Abstract

Objectives: To describe the adaptability to the patterns in symptoms and quality of life (QoL) during 6 months post low-grade glioma diagnosis by valid and reliable tools; to identify through qualitative interviews patient/provider adaptive techniques and strategies; and to assess associations among patient characteristics, symptoms and QoL, and adaptive techniques or strategies.

Data sources: Demographic, clinical and pathologic data from medical records. Validated instruments that assess QoL, fatigue, depression, and distress were completed at 2, 4, and 6 months post diagnosis. Qualitative interviews identifying the symptoms, challenges, adaptive techniques and strategies were conducted at 4 and 6 months.

Conclusion: The most frequently used adaptive strategies included: obtaining community support (87%), managing expectations (73%) and support systems (67%), and seeking out knowledge about physical (67%) and behavioral symptoms (53%). Seizures were reported with IDH1^mut (11%) but not IDH1^wildtype. Patients with either IDH1^mut or TERT^mut consistently reported lower QoL and higher distress, depression, and fatigue scores. IDH1/TERT^mut may be related to lower QoL because of IDH1^mut-related seizures.

Implications for nursing practice: Findings provide a list of adaptive strategies and characteristics to address the problems and symptoms that may improve overall QoL in patients with low-grade glioma.

Keywords: adaptive leadership; glioma; quality of life; symptoms.

FIGURE 1.

QoL reported over time stratified by IDH1 and TERT status. Abbreviations: FACT-Br, Functional Assessment of Cancer Therapy-Brain; FACIT, Functional Assessment of Chronic Illness Therapy.

FIGURE 2.

QoL reported over time stratified by 1p19q status and sex. Abbreviations: FACT-Br, Functional Assessment of Cancer Therapy-Brain; FACIT, Functional Assessment of Chronic Illness Therapy.