Cluser de sintomas em adolescentes com câncer. / Cluser symptoms in adolescents with cancer.

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

07/12/2011

RESUMO

To identify symptom clusters in adolescents with cancer; to determine if the symptom clusters are consistent when using different statistical methods; and to evaluate the reliability and validity of the symptom clusters identified. Methods: it was included a sample of 132 adolescents with cancer (outpatient and inpatients), who presented at least two symptoms with severity higher than mild (score  3 in the 0-10 numeric scale) in the last 24 hours. The symptoms were evaluated using the M.D. Anderson Symptom Inventory (MDASI-core). After providing informed consent, patients were assessed using the following instruments: Lansky Performance Scale or Karnofsky Performance Scale, and the quality of life questionnaires PedsQL 4.0-core and PedsQL 3.0-cancer. Hierarchical cluster analyses (HCA), with Wards and Average Linkage methods, and factor analysis (EFA), with Varimax and Oblimin rotation, were performed to identify symptom clusters. Symptom clusters were assessed in relation to their reliability, discriminant construct validity, and Known-groups validity. Internal consistency was assessed using the Cronbachs alpha test. Results: Some clusters were identified when using the four different statistical methods. Specific names were given to each one. Of those, three were found to be consistent across analyses: first, a gastrointestinal cluster (GI), consisting of nausea, vomiting, and lack of appetite; second, a pain cluster, consisting of pain, drowsiness, and disturbed sleep; and third, a fatigue cluster, consisting of fatigue, dry mouth, sadness, dyspnea, and distress. The GI clusters identified using EFA showed good reliability (=0.70); discriminant construct validity demonstrated by the negative (inverse), satisfactory, moderate and strong correlations with the scores of the quality of life questionnaires; and known-groups validity, as demonstrated by its ability to discriminate between patients with low and high performance status (p=0.001). The GI cluster identified using hierarchical analysis with Wards Method, also shown satisfactory reliability (=0.74). However, only the discriminant construct validity was demonstrated. The pain clusters identified using the four statistical methods demonstrated satisfactory reliability (=0.61), discriminant construct validity, and known-groups validity. The fatigue clusters identified using EFA and HCA, with Average Linkage Method, demonstrated good reliability, (=0.72) and (=0.70), respectively. The fatigue cluster identified using HCA with Wards Method showed satisfactory reliability (=0.63). All fatigue clusters demonstrated only construct validity. Conclusions: The GI, Pain, and Fatigue symptom clusters were notably consistent across EFA and HCA. In general, they demonstrated satisfactory to good reliability, discriminant construct validity, and known-groups validity. These results suggested the presence of symptom clusters in adolescent with cancer.

ASSUNTO(S)

neoplasia sintomas adolescente avaliação enfermagem. neoplasm, symptoms, adolescent, assessment, nursing. enfermagem

ACESSO AO ARTIGO

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