Journal of Shanghai Jiao Tong University (Medical Science) >

2023 , Vol. 43 >Issue 11: 1408 - 1416

DOI: https://doi.org/10.3969/j.issn.1674-8115.2023.11.008

Clinical research

Latent profile analysis of multiple symptom distress in children and adolescents with cancer and its effect on their physical activity

  • Yanyan LIU ,
  • Tiantian YANG ,
  • Nanping SHEN ,
  • Mengxue HE ,
  • Hongyan ZHANG
Expand
  • 1.School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
    2.Nursing Department, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    3.Department of Hematology/Oncology, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    4.Department of Pediatric Hematology/Oncology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
SHEN Nanping, E-mail: shennanping@scmc.com.cn.

Received date: 2023-06-29

  Accepted date: 2023-09-12

  Online published: 2023-10-24

Supported by

National Natural Science Foundation of China(71704106);Innovative Research Team of High-level Local Universities in Shanghai(SHSMU-ZDCX20212800);Nursing Development Program of Shanghai Jiao Tong University School of Medicine(SJTUHLXK2022)

Fold

Abstract

Objective ·To describe the level of multiple symptom distress and physical activity in children and adolescents with cancer, analyze symptom distress profiles, and explicit the relationship between latent profiles and physical activity. Methods ·From November 2021 to March 2023, the convenient sample method was used to recruit children and adolescents with cancer aged 10－18 years old, who had been treated for more than 1 month in the Departments of Hematology/Oncology, Shanghai Children′s Medical Center and Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine. The questionnaires, including General Information Questionnaire, Memorial Symptom Assessment Scale 10-18 (MSAS 10-18) and Modified Chinese Version of Children′s Leisure Time Activities Study Survey (CLASS-C), were used. Latent profile analysis was used to identify whether the level of multiple symptom distress in children and adolescents with cancer was population heterogeneity and its explicit characteristics. Whether there were differences in physical activity levels among different profiles of symptom distress was also analyzed. Results ·A total of 165 valid questionnaires were collected, with an effective response rate of 91.7%. The symptom distress scores of the top five occurrence rates of symptoms in children and adolescents with cancer were lack of energy with a median of 1 (1, 2) point, nausea 1 (1, 2) point, lack of appetite 2 (2, 3) points, sweat 1 (1, 2) point, and pain 1 (1, 2) point. The physical activity level of the patients was mainly light, with a median of 2 530.00 (1 577.50, 3 721.00) min/week, and moderate to vigorous physical activity was relatively lower [70.00 (10.00, 197.50) min/week]. The patients with cancer could be divided into two latent profiles: "high fatigue-high nausea-high hair loss-high sleepy" and "high fatigue-low nausea-low vomiting-low sleepy", which were named as high symptom distress (n=47, 30.6%) and low symptom distress (n=118, 69.4%) separately. Multivariate Logistic regression analysis showed that patients with acute lymphoblastic leukemia were more likely to be classified as high symptom distress group, and outpatients in the latest hospital visit were more likely to classified as low symptom distress group (both P<0.05). In addition, patients with high symptom distress had a higher level of light physical activity (P<0.05), and had a lower level of moderate to vigorous physical activity, but the difference was not statistically significant. Conclusion ·There is population heterogeneity in the multiple symptom distress in children and adolescents with cancer. Disease type (acute leukemia) and the way of the latest hospital visit (through outpatient department) are the predictors of symptoms profiles of patients with cancer. Patients who experience high symptom distress have higher level of light physical activity, and perhaps lower level of moderate to vigorous physical activity.

Key words： symptom distress; cancer; child; adolescent; physical activity; latent class analysis

Cite this article

Yanyan LIU , Tiantian YANG , Nanping SHEN , Mengxue HE , Hongyan ZHANG . Latent profile analysis of multiple symptom distress in children and adolescents with cancer and its effect on their physical activity[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023 , 43(11) : 1408 -1416 . DOI: 10.3969/j.issn.1674-8115.2023.11.008

References

1 World Health Organization. WHO launches new tools to help countries build effective childhood cancer programmes[EB/OL]. (2021-02-15)[2023-06-17]. https://www.who.int/news/item/15-02-2021-who-launches-new-tools-to-help-countries-build-effective-childhood-cancer-programmes.
2 STELIAROVA-FOUCHER E, COLOMBET M, RIES L A G, et al. International incidence of childhood cancer, 2001-10: a population-based registry study[J]. Lancet Oncol, 2017, 18(6): 719-731.
3 倪鑫. 国家儿童肿瘤监测年报[M]. 北京: 人民卫生出版社, 2021.
3 NI X. National pediatric cancer surveillance annual report[M]. Beijing: People′s Medical Publishing House, 2021.
4 RODGERS C, HOOKE M C, WARD J, et al. Symptom clusters in children and adolescents with cancer[J]. Semin Oncol Nurs, 2016, 32(4): 394-404.
5 HE S, YOU L M, ZHENG J, et al. Uncertainty and personal growth through positive coping strategies among Chinese parents of children with acute leukemia[J]. Cancer Nurs, 2016, 39(3): 205-212.
6 BERDAN C A, TANGNEY C C, SCALA C, et al. Childhood cancer survivors and adherence to the American Cancer Society guidelines on nutrition and physical activity[J]. J Cancer Surviv, 2014, 8(4): 671-679.
7 Children′s Oncology Group. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers. Version 5.0[EB/OL]. [2023-02-17]. http://www.survivorshipguidelines.org/pdf/2018/COG_LTFU_Guidelines_v5.pdf.
8 G?TTE M, KESTING S, WINTER C, et al. Comparison of self-reported physical activity in children and adolescents before and during cancer treatment[J]. Pediatr Blood Cancer, 2014, 61(6): 1023-1028.
9 WU W W, YU T H, JOU S T, et al. Physical activity self-efficacy mediates the effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment[J]. Eur J Cancer Care (Engl), 2019, 28(4): e13045.
10 欧阳娜, 蔡瑞卿, 龚霓, 等. 恶性肿瘤患儿治疗期间体力活动阻碍因素的质性研究[J]. 解放军护理杂志, 2019, 36(3): 33-36, 41
10 OUYANG N, CAI R Q, GONG N, et al. The barriers of physical activity for children with malignant tumor during treatment: a qualitative study[J]. Nursing Journal of Chinese People′s Liberation Army, 2019, 36(3): 33-36, 41.
11 BUCKNER T W, WANG J C, DEWALT D A, et al. Patterns of symptoms and functional impairments in children with cancer[J]. Pediatr Blood Cancer, 2014, 61(7): 1282-1288.
12 中国抗癌协会小儿肿瘤专业委员会急性淋巴细胞白血病2015多中心研究协作组. CCCG-ALL-2015方案多中心临床报告[J]. 中华儿科杂志, 2022, 60(10): 1002-1010.
12 Chinese Children′s Cancer Group Acute Lymphoblastic Leukemia 2015 Study Group. Report of Chinese Children′s Cancer Group acute lymphoblastic leukemia 2015 multicenter study[J]. Chinese Journal of Pediatrics, 2022, 60(10): 1002-1010.
13 中华医学会儿科学分会血液学组, 中国抗癌协会儿科专业委员会. 儿童霍奇金淋巴瘤的诊疗建议[J]. 中华儿科杂志, 2014, 52(8): 586-589.
13 Hematology Group of the Pediatrics Branch of the Chinese Medical Association, Pediatrics Committee of the Chinese Anti-Cancer Association. Recommendations for the diagnosis and treatment of children with Hodgkin′s lymphoma[J]. Chinese Journal of Pediatrics, 2014, 52(8): 586-589.
14 张龚巍, 赵彩蕾, 罗娜, 等. CT扫描术前预测高危儿童肝母细胞瘤的价值[J]. 中华放射学杂志, 2021, 55(9): 981-986.
14 ZHANG G W, ZHAO C L, LUO N, et al. Predictive value of CT imaging features in preoperative high-risk group of childhood hepatoblastoma[J]. Chinese Journal of Radiology, 2021, 55(9): 981-986.
15 COLLINS J J, BYRNES M E, DUNKEL I J, et al. The measurement of symptoms in children with cancer[J]. J Pain Symptom Manag, 2000, 19(5): 363-377.
16 PORTENOY R K, THALER H T, KORNBLITH A B, et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress[J]. Eur J Cancer, 1994, 30(9): 1326-1336.
17 冯芳茗, 楼建华, 徐红, 等. 癌症患儿症状体验的现况调查[J]. 中国护理管理, 2012, 12(1): 30-34.
17 FENG F M, LOU J H, XU H, et al. Symptom experience among children with cancer: a cross-sectional study[J]. Chinese Nursing Management, 2012, 12(1): 30-34.
18 TELFORD A, SALMON J, JOLLEY D, et al. Reliability and validity of physical activity questionnaires for children: the Children′s Leisure Activities Study Survey (CLASS)[J]. Pediatr Exerc Sci, 2004, 16(1): 64-78.
19 HUANG Y J, WONG S H S, SALMON J. Reliability and validity of the modified Chinese version of the Children′s Leisure Activities Study Survey (CLASS) questionnaire in assessing physical activity among Hong Kong children[J]. Pediatr Exerc Sci, 2009, 21(3): 339-353.
20 李海燕, 陈佩杰, 庄洁. 儿童休闲活动调查问卷修订与信效度评价[J]. 中国学校卫生, 2011, 32(3): 268-270.
20 LI H Y, CHEN P J, ZHUANG J. Revision and reliability validity amassment of Children′s Leisure Activities Study Survey[J]. Chinese Journal of School Health, 2011, 32(3): 268-270.
21 杨静. 恶性肿瘤患儿住院期间体力活动状况及其影响因素的研究[D]. 广州: 中山大学, 2016.
21 YANG J. The physical activity status of inpatient children with cancer and its influencing factors[D]. Guangzhou: Sun Yat-sen University, 2016.
22 WANG J C, WANG X Q. Structural equation modeling: applications using Mplus[M]. New Jersey: John Wiley & Sons, 2012.
23 郑渊, 刘可, 卜秀青, 等. 急性白血病患儿化疗期间症状群的调查分析[J]. 中华护理杂志, 2016, 51(11): 1320-1324.
23 ZHENG Y, LIU K, BU X Q, et al. Survey and analysis of symptom clusters in children with acute leukemia during chemotherapy[J]. Chinese Journal of Nursing, 2016, 51(11): 1320-1324.
24 SADRUDDIN M M, HAMEED-UR-REHMAN M. Understanding the perceptions of children battling cancer about self and others through drawing[J]. South Asian J Cancer, 2013, 2(3): 113-118.
25 BELUM V R, WASHINGTON C, PRATILAS C A, et al. Dermatologic adverse events in pediatric patients receiving targeted anticancer therapies: a pooled analysis[J]. Pediatr Blood Cancer, 2015, 62(5): 798-806.
26 LAROUCHE S S, CHIN-PEUCKERT L. Changes in body image experienced by adolescents with cancer[J]. J Pediatr Oncol Nurs, 2006, 23(4): 200-209.
27 DORR V J. A practitioner′s guide to cancer-related alopecia[J]. Semin Oncol, 1998, 25(5): 562-570.
28 CHUNG O K, LI H C W, CHIU S Y, et al. The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors[J]. Cancer Nurs, 2014, 37(3): E43-E51.
29 GRIMSHAW S L, TAYLOR N F, MECHINAUD F, et al. Physical activity for children undergoing acute cancer treatment: a qualitative study of parental perspectives[J]. Pediatr Blood Cancer, 2020, 67(6): e28264.
30 LAM K K, HO CHEUNG WILLIAM L, HO K Y E, et al. Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer: an exploratory study[J]. J Clin Nurs, 2017, 26(1/2): 190-201.
31 OUYANG N, CAI R Q, ZHOU X Z, et al. Effects of a group-based physical activity program for pediatric patients with cancer on physical activity and symptom experience: a quasi-experimental study[J]. Pediatr Blood Cancer, 2019, 66(11): e27965.
32 CHEUNG A T, LI W H C, HO L L K, et al. Efficacy of mobile instant messaging-delivered brief motivational interviewing for parents to promote physical activity in pediatric cancer survivors: a randomized clinical trial[J]. JAMA Netw Open, 2022, 5(6): e2214600.
33 WU W W, LIN K C, LIANG S Y, et al. Using a patient-centered approach to identify symptom clusters among adolescents with cancer[J]. Cancer Nurs, 2019, 42(3): 198-207.
34 WANG J C, JACOBS S, DEWALT D A, et al. A longitudinal study of PROMIS pediatric symptom clusters in children undergoing chemotherapy[J]. J Pain Symptom Manage, 2018, 55(2): 359-367.
35 AMERINGER S, ELSWICK R K Jr, SHOCKEY D P, et al. A pilot exploration of symptom trajectories in adolescents with cancer during chemotherapy[J]. Cancer Nurs, 2013, 36(1): 60-71.
36 徐艳华. 基于潜在剖面分析的白血病儿童多症状特征的初步异质性研究[D]. 上海: 上海交通大学, 2018.
36 XU Y H. A pilot heterogeneity research of multiple symptom patterns in children with leukemia based on latent profile analysis[D]. Shanghai: Shanghai Jiao Tong University, 2018.
37 SAMPASA-KANYINGA H, COLMAN I, GOLDFIELD G S, et al. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review[J]. Int J Behav Nutr Phys Act, 2020, 17(1): 72.
Options
Outlines

/

〈 〉