Stress, Symptom, Symptom Distress, and Symptom Self-Management in Localized Prostate Cancer
AdvisorMoore, Ida M. (Ki)
Committee ChairMoore, Ida M. (Ki)
MetadataShow full item record
PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractProstate cancer is the most commonly diagnosed cancer and second leading cause of death in American men. Patients with localized prostate cancer may experience unique and multidimensional symptoms that are distressful from treatment and thereafter. This cross-sectional correlational study aimed to investigate the relationships among stress, symptoms, symptom distress, and symptom self-management and identify the effective strategies of symptom self-management in men with localized prostate cancer following prostatectomy or radiation therapy.Eight saliva samples and 3 questionnaires (Perceived Stress Scale, Symptom Indexes, and Strategy and Effectiveness of Symptom Self-Management) were obtained from each participant between 1 and 3 months following their first prostate cancer treatment. The sample consisted of 53 men with localized prostate cancer. Mean salivary cortisol concentrations for the entire sample ranged from 0.3 to 0.08 ug/dL. Cortisol was secreted in a circadian rhythm with heightened activity in the early morning and lowered activity late in the day. The circadian pattern of cortisol secretion was similar in both the prostatectomy and radiation therapy groups, although the values were slightly different. Two areas Under the Curve (AUC) of salivary cortisol were calculated. Three cortisol circadian rhythms were identified, but the majority of the sample had a typical negative consistent circadian rhythm.Patients with localized prostate cancer who underwent radical prostatectomy or radiation therapy had low perceived stress. Perceived stress was positively correlated with AUCg, noon salivary cortisol concentrations, and afternoon salivary cortisol concentrations. Subjects reported a moderate degree of symptoms and symptom distress on urinary, bowel, and sexual dysfunction 1-3 months following treatments. The most effective strategies of urinary symptom management were pad and kegel exercise; the most effective strategy of bowel symptom management was rest or endure; the most effective strategies of sexual dysfunction management included express their feelings or find alternative ways to express their affection. The symptom self-management strategies were significantly and positively correlated with symptom self-management effectiveness.Symptom distress and AUCg were significant and strong predictors of symptom self-management. Findings can help health care providers develop effective strategies for symptom self-management that enhance health related quality of life among men with localized prostate cancer.
Degree GrantorUniversity of Arizona
Showing items related by title, author, creator and subject.
Mexican American Women and Breast Cancer-Comorbidities, Symptom Frequency, Symptom Distress, Symptom Management, and Social SupportBurrell, Carlitta Danielle (The University of Arizona., 2018)This descriptive secondary data analysis examined the influence of comorbidity on medication use, symptom frequency, symptom distress, symptom management, social support and social network among Mexican American (MA) women with breast cancer. The total sample included 149 participants. The mean age of the sample was 50.49 years old—young compared to the U.S. national average age at breast cancer diagnosis of 62 years old. Nearly half of the women reported no comorbidities (n = 71), and n = 78 reported one or more comorbidities. Significant between groups differences showed that the comorbidity group was approximately 10 years older than the no comorbidity group, used more medications, and had twice the social network than the younger no comorbidity group. While the comorbidity group did report more symptom distress than the no comorbidity group, in both groups, the majority of participants reported moderate to high levels of symptom distress. Likewise, there was a small, significant between groups difference for symptom frequency. In both groups, over half of the participants reported having 3-7 symptoms. Correlations between variables showed a relationship between increased symptom frequency and decreased symptom management, and a relationship between higher symptom distress and lower symptom management. Emotional social support showed a positive influence on symptom frequency and symptom distress, providing evidence that social support is beneficial in improving breast cancer outcomes. Additional findings include evidence that low socioeconomic status (SES) contributes to cancer health disparities. The overall similarity between the groups suggests that the effects of comorbidity may not have as much influence as would be expected, and SES and other social and contextual factors may have an effect of equalizing the groups for some variables measured in this study.
Adolescent risk preference and asthma symptom self-management: Assessing symptom management scenariosCook, Susanne Welch (The University of Arizona., 2004)Adolescent asthma symptom self-management choices frequently involve uncertain outcomes that include potential dangers such as trigger exposures or delays in treatments that can lead to increased morbidity or mortality. Nurses must understand factors that influence how adolescents make symptom decisions. The purpose of the investigation was to assess eight adolescent asthma symptom scenarios for use with the standard gamble technique (SGT) for making choices. The aims were to: (1) estimate the internal consistency and content validity of the scenarios; (2) estimate the relationship between measured risk preferences, age, and gender; and (3) describe adolescent responses to using the SGT. Thirty-six adolescents participated. Risk preferences or utilities elicited during face-to-face interviews with 31 adolescents were used to answer research questions. Data were analyzed using descriptive statistics, Cronbach's alpha, Kendall's tau correlations, and point biserial correlations. Content validity (CV) ratings from 36 adolescents were used to compute indexes and establish CV of the scenarios. Qualitative responses were analyzed using a modified case study strategy to further establish CV and assess using SGT with adolescents. The estimates of internal consistency reliability and relationships between utilities, age, and gender were limited by the non-normal distributions of utility and age data sets and small sample size. The standardized alpha was .70 for the eight-scenario composite. Eight significant inter-item correlations and seven significant item-total correlations were identified. One significant correlation between age and an individual scenario utility score was found. No significant relationships between age and mean utility scores or gender and the individual or mean utility scores were seen. The CV indexes support the relevancy of the content of the eight-scenario composite as evidenced by 94.5% of the adolescents rating the individual scenarios as CV for the domains and 92% for the risk areas. In addition, the adolescents rated 94% percent of the composites as CV. The qualitative responses support the quantitative data and describe the SGT as a method that adolescents can use. Future studies are needed with a larger sample to further examine the internal consistency of the scenarios and the relationships between age, gender, and utility scores measured with the SGT.
Symptom Clusters and Trajectories of Depression and Anxiety in Latina Breast Cancer SurvivorsCrane, Tracy E. (The University of Arizona., 2016)Background: Latinas experience a greater number of symptoms and are at an elevated risk for depression and anxiety following a diagnosis of breast cancer compared to Non-Hispanic Whites and African Americans. Cancer-related symptom clusters are frequently reported in women with breast cancer and research suggests these women follow distinct trajectories for depression and anxiety. However, little is known about the trajectories of anxiety and depression or cancer-related symptom clusters in Latinas with breast cancer. Methods: 296 Latinas previously recruited and diagnosed with breast cancer comprised this sample. Questionnaires for depression (the Center for Epidemiological Studies-Depression) and Anxiety (Speilberger State-Trait Inventory and PROMIS Anxiety) were administered at baseline, 2 and 4 months post enrollment. To identify classes of Latina breast cancer survivors based on patterns of symptom occurrence, symptoms latent class analysis was used to describe symptom clusters. Group-based growth mixture modeling was utilized to identify classes of women who followed distinct trajectories of depression and anxiety. Results: On average women reported 4.2±3 symptoms with an overall symptom distress score of 6.4±2.5 (out of a scale of 10). Three symptom classes were identified: Weary and Sleepy (class 1), Weary (class 2) and Weary, Sleepy and Hurting (class 3). Women were most likely to cluster in class 1, followed by class 2 and 3 with fatigue (labeled weary) being the most prevalent symptom for all three classes. Three trajectories emerged for both depression and anxiety. For depression, the majority of women (79.6%) fell in the high then reducing trajectory for depression followed by the low and remaining low (17%) and the high and increasing (worsening) trajectories of depression (3%). For anxiety the majority (78% of women) followed the moderate to increasing (worsening) trajectory of anxiety followed by 14% in the moderate to declining (improving) and 8% in the low to slightly increasing (worsening) trajectories for anxiety. Conclusion: This study suggests Latina breast cancer survivors experience burdensome cancer-related symptom clusters and distinct trajectories for depression and anxiety. Further research is needed in minority women with breast cancer to adequately understand and treat cancer-related symptom clusters as well as depression and anxiety.