Higher Levels of Stress Are Associated with a Significant Symptom Burden in Oncology Outpatients Receiving Chemotherapy
- Author(s): Jakovljevic, Katarina
- Advisor(s): Miaskowski, Christine
- et al.
Background: A cancer diagnosis and associated treatments, as well as the uncertainty of the
disease course, are stressful experiences for most patients. However, little information is
available on the relationship between stress and symptom burden. The study purpose was to
evaluate for differences in the severity of fatigue, lack of energy, sleep disturbance, and
cognitive function, among three groups of patients with distinct stress profiles.
Methods: Patients receiving chemotherapy (n=957) completed measures of general, cancer
specific, and cumulative life stress and symptom inventories. Latent profile analysis was used to
identify subgroups of patients with distinct stress profiles.
Results: Three distinct subgroups of patients were identified (i.e., Stressed (39.3%), Normative
(54.3%), Resilient (5.7%)). For cognitive function, significant differences were found among the
latent classes (Stressed
evening fatigue, compared to the Normative and Resilient classes, the Stressed class reported
higher severity scores. Compared to the Normative and Resilient classes, the Stressed class
reported low levels of morning energy. Compared to the Normative class, the Stressed class
reported lower levels of evening energy.
Conclusions: Consistent with our a priori hypothesis, patients in the Stressed class had the
highest symptom severity scores for all four symptoms and all of these scores were above the
clinically meaningful cutoffs for the various instruments.