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Prevalence and correlates of symptoms and uncertainty in illness among head and neck cancer patients receiving definitive radiation with or without chemotherapy.

Mary Ellen Haisfield-Wolfe; Deborah B McGuire; Karen Soeken; Jeanne Geiger-Brown; Bruce De Forge; Mohan Suntharalingam (Profiled Authors: Mohan Suntharalingam; Jeanne Geiger-Brown)

Acute and Chronic Care Department, Johns Hopkins University, School of Nursing, 525 North Wolfe Street, Baltimore, MD 21205-2110, USA. mhaisfi1@son.jhmi.edu
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2012;20(8):1885-93.

PURPOSE: This repeated measures, prospective study was designed to explore and describe symptom dimensions, depressive symptoms, and uncertainty in newly diagnosed oropharyngeal and laryngeal cancer patients during and 1 month following treatment. MATERIALS AND METHODS: A non-probability sample of 21 oropharyngeal and laryngeal cancer patients receiving definitive radiation completed the Memorial Symptom Assessment Scale, Beck Depression Inventory, and Mishel's Uncertainty in Illness Scale at treatment initiation, and at 5, 9, and 12 weeks. RESULTS: A common pattern of 11 symptoms, which changed as treatment progressed, was problematic for patients. Physical symptoms increased by 50% at week 5 and 9. Depression was experienced by 24% of patients. Uncertainty was found to be high at all time points and unexpectedly remained unchanged over time (p = 0.73). Positive correlations (p < 0.05) were found among number of symptoms, symptom distress, and depressive symptoms. Uncertainty was correlated (p < 0.05) statistically only to symptom distress. CONCLUSION: This study is the first to identify uncertainty in illness among oropharyngeal and laryngeal cancer patients and found it to be higher than for other cancer populations. Findings provide insights into the uncertainty of living through treatment and provide information for patient care. The consistent pattern of high levels of uncertainty during and 1 month after treatment suggests that the uncertainty related to acute illness could extend into chronic uncertainty which may interfere with a cancer survivor's adaption to daily living after treatment. Further research is needed to investigate other variables that influence uncertainty during treatment as well as 1 to 6 months after treatment for head and neck cancer.

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