Risk Factors for a Higher Symptom Burden in Patients With Cancer During the COVID-19 Pandemic

Ji Hun Kwak

Lynda A. Mackin

Astrid Block

Steven M. Paul

Bruce A. Cooper

Maura Abbott

Susan M. Chang

Marilyn J. Hammer

Kord M. Kober

Jon D. Levine

Rachel Pozzar

Kim F. Rhoads

Karin E. Snowberg

Katy K. Tsai

Erin L. Van Blarigan

Katherine Van Loon

Christine Miaskowski

COVID-19, anxiety, depression, fatigue, loneliness, social isolation
ONF 2023, 50(5), 647-664. DOI: 10.1188/23.ONF.647-664

Objectives: To evaluate for subgroups of patients with distinct symptom profiles and differences in demographic and clinical characteristics and stress and resilience among these subgroups.

Sample & Setting: 1,145 patients with cancer aged 18 years or older completed a survey online. Data were collected between May 2020 and February 2021.

Methods & Variables: Patients completed measures for depression, state anxiety, cognitive function, morning fatigue, evening fatigue, morning energy, evening energy, sleep disturbance, pain, stress, and resilience. Latent class profile analysis was used to identify subgroups of patients with distinct symptom profiles. Differences among the subgroups on study measures were evaluated using parametric and nonparametric tests.

Results: Four distinct profiles were identified (none, low, high, and very high). Patients in the high and very high classes reported clinically meaningful levels of all nine symptoms. Differences among the four profiles for stress and resilience exhibited a dose–response effect.

Implications for Nursing: Findings can serve as benchmark data of the symptom burden of patients with cancer following the COVID-19 pandemic.

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