• Oncology nursing forum · Jul 2007

    Relationships among pain, fatigue, insomnia, and gender in persons with lung cancer.

    • Amy J Hoffman, Barbara A Given, Alexander von Eye, Audrey G Gift, and Charles W Given.
    • National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA. ahoffman32@aol.com
    • Oncol Nurs Forum. 2007 Jul 1;34(4):785-92.

    Purpose/ObjectivesTo examine the relationships among pain, fatigue, insomnia, and gender while controlling for age, comorbidities, and stage of cancer in patients newly diagnosed with lung cancer within 56 days of receiving chemotherapy.DesignSecondary data analysis.SettingAccrual from four sites: two clinical community oncology programs and two comprehensive cancer centers.Sample80 patients newly diagnosed with lung cancer.MethodsAnalysis from baseline observation of a randomized clinical intervention trial. Multinomial log-linear modeling was performed to explain the relationships among pain, fatigue, insomnia, and gender.Main Research VariablesPain, fatigue, insomnia, and gender.FindingsFor all people with lung cancer, fatigue (97%) and pain (69%) were the most frequently occurring symptoms; insomnia occurred 51% of the time. A model containing all main effects (two-way interactions of pain and fatigue, pain and insomnia, and insomnia and gender; and the three-way interaction of pain, fatigue, and insomnia, along with three covariates [age, comorbidities, and stage of cancer]) was a good fit to the data. Parameter estimates indicated that a statistically significant effect from the model was the three-way interaction of pain, fatigue, and insomnia. Gender did not make a difference. Age, comorbidities, and stage of cancer were not significant covariates.ConclusionsFor people newly diagnosed with lung cancer undergoing chemotherapy, multiple symptoms occur simultaneously rather than in isolation; a symptom cluster exists, consisting of pain, fatigue, and insomnia; and no relationship was found among gender, pain, fatigue, and insomnia.Implications For NursingBy understanding this symptom cluster, healthcare providers can target specific troublesome symptoms to optimize symptom management and achieve the delivery of high-quality cancer care.

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