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.
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.
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.
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).
Multiple symptoms were experienced across the cycle. Three symptoms displayed significant trajectories indicating that patterns of symptoms may be anticipated.
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.