Background: Chemotherapy is frequently administered in repetitive cycles. Adolescents with cancer have multiple symptoms related to chemotherapy, but knowledge of symptom trajectories across a cycle is limited. Examining trajectories over a cycle may reveal key periods to manage symptoms.
Objectives: The aims of this pilot were to describe the trajectory of symptoms (pain, sleep, appetite, nausea, fatigue) and biological and behavioral variables (anxiety, stress, hematologic function) across 1 cycle and examine relationships between variables.
Methods: Nine adolescents with cancer within 6 months of diagnosis participated. Data were collected by surveys, chart review, and biologic measures on days 1 and 2 of the cycle, 1 week later (nadir), and day 1 of the following cycle. To evaluate the trajectory, a simple random-effects repeated-measures analysis was computed.
Results: The significant trajectories were fatigue (P = .003), difficulty sleeping (P = .032), and nausea (P = .04). Most of the adolescents reported some anticipatory anxiety about receiving chemotherapy. Significant correlations between symptoms and biobehavioral variables included anticipatory anxiety and nausea (r = .86, P = .003), trait anxiety and fatigue (r = −0.82, P < .001), and stress and pain (r = 0.78, P = .039).
Conclusions: Multiple symptoms were experienced across the cycle. Three symptoms displayed significant trajectories indicating that patterns of symptoms may be anticipated.
Implications for Practice: Pilot findings suggest that monitoring symptoms, stress, and anxiety across a cycle is important, not only during chemotherapy administration, but also prior to being admitted for chemotherapy.
Author Affiliations: School of Nursing (Drs Ameringer and Elswick) and Division of Pediatric Hematology/Oncology (Mss Shockey and Dillon), Virginia Commonwealth University Health Systems, Richmond.
This work was supported in part by a grant from the National Institute ofNursing Research (P20 NR008988, “Biobehavioral Research in Critical Health Experiences,” N. McCain, principal investigator).
The authors have no conflicts of interest to disclose.
Correspondence: Suzanne Ameringer, PhD, RN, School of Nursing, Virginia Commonwealth University, 1100 E Leigh St, Richmond, VA 23219 (firstname.lastname@example.org).
Accepted for publication February 16, 2012.