The Symptom Experience of Patients with Advanced Melanoma Undergoing Immune Checkpoint Inhibitor (ICI) Therapy.

Autor: Jackson-Carroll N; Cizik School of Nursing, The University of Texas Health Science Center at Houston; Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: njcarrollnp@gmail.com., Johnson C; Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX., Tawbi H; Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX., Wang XS; Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, TX., Whisenant M; Department of Behavioral Science, University of Texas MD Anderson Cancer Center; Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX.
Jazyk: angličtina
Zdroj: Seminars in oncology nursing [Semin Oncol Nurs] 2024 Feb; Vol. 40 (1), pp. 151574. Date of Electronic Publication: 2024 Jan 14.
DOI: 10.1016/j.soncn.2023.151574
Abstrakt: Objectives: The advent of immune checkpoint inhibitor (ICI) therapy has vastly improved outcomes for patients with advanced melanoma. However, the symptom burden and intensity with their impact on quality-of-life (HRQoL) and functionality are heterogeneous and unpredictable. We used descriptive exploratory content analysis from interviews to capture the patient experience after they had completed quantitative data collection of their symptom burden and interference with the use of two patient-reported outcome (PRO) instruments.
Data Sources: Participants from a single center with advanced melanoma (n = 19) who are undergoing ICI therapy completed the Modified MD Anderson Symptom Inventory and Functional Assessment of Cancer Therapy-Melanoma and recorded semistructured interviews. Interpretive description informed the inductive and iterative analysis approach.
Conclusion: Participants had a heterogenous experience of ICI and melanoma-related symptoms: distress (84%), fatigue (68%), rash or skin changes (53%), pain (30%), diarrhea (30%), itching (26%), and shortness of breath (21%), with varying interference within HRQoL domains, mood (47%), relations with other people (26%), and activity (21%). Some noted a lack of physical interference (79%). Uncertainty was a pervasive theme in the interviews (68%) despite the majority having positive thoughts about ICI therapy (58%) and expectations of the success of therapy (53%). The physical and emotional burden of a melanoma diagnosis, undergoing therapy, and the uncertainty of the outcomes are pervasive for patients.
Implications for Nursing Practice: Communication surrounding the diagnosis, prognosis, treatment options, and outcomes need to be clear and acknowledge there are unknowns. Nurses may benefit from using a validated PRO instrument to help document and understand the patient's symptom experience while undergoing ICI therapy.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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