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. 2021 Oct;29(10):5895-5904.
doi: 10.1007/s00520-021-06159-z. Epub 2021 Mar 24.

Measurement of patients' acceptable symptom levels and priorities for symptom improvement in advanced lung cancer

Ellen Krueger  1 , Ekin Secinti  2 , Wei Wu  2 , Nasser Hanna  3 , Gregory Durm  3 , Lawrence Einhorn  3 , Shadia Jalal  3 , Catherine E Mosher  2
Affiliations

Measurement of patients' acceptable symptom levels and priorities for symptom improvement in advanced lung cancer

Ellen Krueger et al. Support Care Cancer. 2021 Oct.

Abstract

Purpose: Little research has assessed cancer patients' success criteria and priorities for symptom improvement to inform patient-centered care. Thus, we modified and tested a measure of these constructs for advanced lung cancer patients. We compared acceptable severity levels following symptom treatment across eight symptoms and identified patient subgroups based on symptom importance.

Methods: Advanced lung cancer patients (N=102) completed a one-time survey, including the modified Patient-Centered Outcomes Questionnaire (PCOQ), standard symptom measures, and other clinical characteristics.

Results: The modified PCOQ showed evidence of construct validity through associations with theoretically related constructs. Symptom severity and importance were moderately correlated. Levels of acceptable symptom severity were low and did not differ across the eight symptoms. Four patient subgroups were identified: (1) those who rated all symptoms as low in importance (n=12); (2) those who rated bronchial symptoms and sleep problems as low in importance and all other symptoms as moderately important (n=29); (3) those who rated nausea and emotional distress as low in importance and all other symptoms as moderately important (n=23); and (4) those who rated all symptoms as highly important (n=33). Subgroups were unrelated to clinical characteristics, except for functional status.

Conclusion: The modified PCOQ showed evidence of construct validity. Patients considered low symptom severity to be acceptable, irrespective of the symptom. Findings suggest that symptom severity and importance are related yet distinct aspects of the advanced lung cancer symptom experience. Patients have heterogeneous priorities for symptom improvement, which has implications for tailoring treatment.

Keywords: Advanced lung cancer; Latent profile analysis; Patient-centered care; Patient-centered outcomes; Symptom importance; Symptom severity.

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Conflict of interest statement

Conflicts of interest: The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient subgroups’ mean importance ratings on the Patient Centered Outcomes Questionnaire (PCOQ). N = 97
See this image and copyright information in PMC

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