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A Longitudinal Study of Symptoms and Self-care Activities in Women Treated With Primary Radiotherapy for Breast Cancer

Knobf, M. Tish PhD, RN, FAAN, AOCN; Sun, Yiyuan MSN, RN


The purpose of this prospective longitudinal study was to describe the occurrence, severity, and pattern of symptoms experienced by women during and after primary radiation therapy for breast cancer. A convenience sample of 30 women was recruited from a community hospital. The Symptom Profile by King et al (Oncology Nursing Forum. 1985;12(4):55–61) was adapted to measure 11 symptoms, and the Profile of Mood States assessed psychological status. Data were collected weekly during radiation and monthly for 3 months after treatment. There was a pattern of increasing incidence during treatment for the most commonly reported symptoms: fatigue (33%–93%), skin changes (36%–100%), sensation changes (28%–79%), and breast swelling (11%–38%), with gradual improvement over the following 3 months. Sleep problems were reported by nearly half of the subjects during and after treatment. Severity ratings of symptoms were mild to moderate but significantly higher by the end of therapy (P ≤ .01). There were no significant differences in psychological mood states during or after treatment except for the fatigue subscale (P ≤ .05). These findings will assist the nurse in preparing women for predictable symptoms during and after a course of breast irradiation and direct assessment, and provide data to support evidence-based interventions to minimize symptom distress.

American Cancer Society (Dr Knobf), and Yale University School of Nursing (Dr Knobf and Ms Sun), New Haven, Conn.

Corresponding author: M. Tish Knobf, PhD, RN, FAAN, AOCN, Yale University School of Nursing, 100 Church St S, New Haven, CT 06534 (e-mail:

This work was partially supported by a grant from the American Cancer Society (American Cancer Society Professorship of Oncology Nursing) and from the US Army Breast Cancer Research Program (grant DAMD 17-00-1-0509 Dr Tish Knobf, Co-program Director).

The authors thank Cynthia Teeple, MSN, RN, for her foundational work in the previous pilot study; Elizabeth Strand, MSN, RN, and Margaret Brigham, MSN, RN, for their work with the early analysis; Drs Knowlton and Cardinale, and the staff in the Department of Radiation Therapy at the Hospital of St. Raphael, New Haven, Conn; and George Knafl, PhD, for his support with the statistical analysis.

Accepted for publication January 4, 2005.

© 2005 Lippincott Williams & Wilkins, Inc.