Logo image
Understanding Symptom Burden in Patients With Advanced Cancer Living in Rural Areas
Journal article   Peer reviewed

Understanding Symptom Burden in Patients With Advanced Cancer Living in Rural Areas

Stephanie Gilbertson-White, Yelena Perkhounkova, Seyedehtanaz Saeidzadeh, Maria Hein, Rachel Dahl and Andrean Simons-Burnett
Oncology nursing forum, Vol.46(4), pp.428-441
07/01/2019
DOI: 10.1188/19.ONF.428-441
PMCID: PMC6642634
PMID: 31225835

View Online

Abstract

To evaluate the feasibility of using a biobehavioral approach to examine symptom burden in rural residents with advanced cancer. 21 patients with advanced lung, colorectal, or pancreatic cancer were enrolled at the University of Iowa in Iowa City. Using Cleeland's cytokine-immunologic model of symptom expression, symptom burden (i.e., severity, count, and interference) and inflammatory cytokines were measured for 24 weeks. Potential predictors included demographics, clinical characteristics, optimism, social support, and cancer-related stress. Descriptive statistics, Wilcoxon rank-sum, and Fisher's exact test were used for analysis. Recruitment and retention rates were similar for rural and nonrural patients. Demographics, optimism, and social support were no different between groups. The cancer-related stress total score for rural patients was nearly half of the score of nonrural patients, with rural patients reporting significantly less avoidance. Symptom severity for the five worst symptoms remained moderate during the 24 weeks, whereas nonrural residents reported steady declines in severity of their five worst symptoms. Significant differences in inflammatory cytokines between groups were only found at one time point. Rural residents who seek care at a cancer center may be clinically and demographically more similar to their nonrural counterparts than to rural residents seeking local care.
Adult Aged Aged, 80 and over Colorectal Neoplasms - physiopathology Colorectal Neoplasms - psychology Cost of Illness Female Humans Logistic Models Lung Neoplasms - physiopathology Lung Neoplasms - psychology Male Middle Aged Pancreatic Neoplasms - physiopathology Pancreatic Neoplasms - psychology Rural Population United States

Details

Metrics

Logo image