A path analysis modeling the symptom experience of cancer patients commencing adjuvant treatment in ambulatory clinics

Skerman, Helen M., Yates, Patsy, & Battistutta, Diana (2007) A path analysis modeling the symptom experience of cancer patients commencing adjuvant treatment in ambulatory clinics. Oncology Nursing Forum, 34(1), p. 214.


Typically, patients experience multiple concurrent symptoms, or symptom clusters, in relation to cancer, its treatment, or the combined effect. Exploratory research of symptom clusters has established relationships between the most frequently occurring and bothersome symptoms for many cancers and treatments. There is a need for research to address the underlying relationships associated with the symptom experience of cancer patients, to improve patient outcomes following treatment. The purpose of this project is to conduct a secondary data analysis to test the complex relationships that exist between cancer-related symptoms, the medical antecedents, and consequences for patients, following ambulatory care treatment. The Theory of Unpleasant Symptoms (Lenz et al 1997) proposes physiologic, psychologic and situational factors interact with each other in relation to the symptom experience, resulting in problems associated with cancer and its treatment. Studies suggest the impact of cancer varies according to the diagnosis, stage of disease, type of treatment and non-medical factors, such as social support, age and gender. A sample of 219 adult cancer patients, about to commence adjuvant treatment, was consecutively recruited from two public hospitals in Brisbane. A secondary data analysis, implementing a path analysis, will model the influences between demographic, illness and social variables, the symptom experience, and patients’ performance outcomes. A modified Rotterdam Symptom Checklist assessed patients’ symptom experience indicating prevalence and distress of each symptom. Outcomes in the model are the ECOG performance status, assessed by an oncologist, and global quality of life, determined by self-report on the CARES-SF and a Life Satisfaction instrument developed by the Centre for Mental Health at Queensland University of Technology. Perceived social support, measured by the Social Support Questionnaire for Transactions, will be incorporated as an independent predictor and a mediator between demographic and illness variables and the symptom experience. These instruments have reported moderate to good reliability and validity. The majority of cancer symptom cluster research has been exploratory, utilising factor or cluster analysis. Path models allow the direct and indirect effects of variables to be considered with the potential to highlight a specific opportunity for intervention to improve cancer patient outcomes.

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ID Code: 10208
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: ambulatory care, cancer patients, chemotherapy, adjuvant, neoplasms, symptoms, conceptual framework, secondary analysis, theory
ISSN: 1538-0688 ; 0190-535X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Tertiary (Rehabilitative) (111004)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2007 Oncology Nursing Society
Deposited On: 18 Oct 2007 00:00
Last Modified: 19 May 2010 15:59

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