Symptom perception and functioning in patients with advanced cancer

• Published in: PloS one Vol. 16; no. 2; p. e0245987
• Main Authors: Yang, Eun Joo, Lee, Keun Seok, Lim, Myong Cheol, Baek, Ji Yeon, Han, Ji-Youn, Yu, Eun-Seung, Chung, Seung Hyun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04.02.2021; Public Library of Science (PLoS)
• Subjects: Activities of daily living; Anorexia; Biology and Life Sciences; Breast cancer; Cancer patients; Chemotherapy; Chi-square test; Demographic aspects; Disability; Evaluation; Executive function (Psychology); Fatigue; Gynecology; Hospitals; Hypotheses; Integration; Internal medicine; Lung cancer; Mathematical models; Maximum likelihood method; Medicine; Medicine and Health Sciences; Monte Carlo simulation; Numerical integration; Pain; Social Sciences; Statistical analysis; Statistical models; Statistical tests; Symptomatology; Values; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0245987

To explore how symptom perception affects functioning in patients with advanced cancer. We conducted a cross-sectional observational study of 459 advanced cancer patients at the national cancer center. Functioning was assessed using the World Health Organization Disability Assessment Schedule (WHODAS) II, and symptoms were evaluated using the Memorial Symptom Assessment Scale-Short Form. Confirmatory factor analysis was conducted to develop a structural model based on different symptom perceptions, such as somatic sensation and experienced symptoms. The structural model of disability revealed a significant direct pathway involving somatic sensation (β = 16.11, p < 0.001). Experienced symptoms significantly affected somatic sensations (β = 0.717, p < 0.001) but were not directly associated with disability. Unidimensional models exhibited a poor fit. In contrast, a complex model with first-order (somatic sensation) and second-order (experienced symptoms) factors provided an excellent fit, with comparative fit indexes (CFIs) and Tucker Lewis indexes (TLI) of more than 0.950 threshold. Our findings suggest that relationships to functioning may vary between somatic sensations versus experienced symptoms. The structure of symptoms is best conceptualized by direct somatic sensation and indirect experienced symptoms. A better understanding of symptom perception and the relationship between symptoms and function would facilitate the development of effective rehabilitation programs.