Patterns of symptoms in women after gynecologic surgery.

PURPOSE/OBJECTIVES To explore patterns of symptoms over time and the relationships between selected demographic and clinical characteristics. DESIGN Secondary analysis of longitudinal data. SETTING A hospital and comprehensive cancer center in the northeastern United States. SAMPLE 66 women with gynecologic cancers, postsurgical, and scheduled to receive chemotherapy. METHODS A secondary analysis using descriptive and general estimating equation statistical procedures was conducted on symptom and disease data in a subset of a larger nursing intervention study. MAIN RESEARCH VARIABLES Demographic and clinical variables including cancer site, new diagnosis or recurrence, stage, treatment, comorbidities, emotional distress, use of a symptom management tool kit, and 10 symptoms over time. FINDINGS Two patterns of symptoms were identified. The first pattern (pain, bowel dysfunction, disturbed sleep, depression, nausea, and lack of appetite) decreased, and the second pattern (fatigue, anxiety, hair loss, and numbness) remained constant over time. The total number of symptoms decreased over time. Factors associated with symptoms, such as the use of a tool kit and emotional distress, were identified. CONCLUSIONS Tool kit use by women who experienced fatigue, bowel dysfunction, and anxiety suggests its usefulness as a self-care guide. Explanations for the two patterns of symptoms are discussed. IMPLICATIONS FOR NURSING Postsurgical management should include management and monitoring of symptoms associated with treatment. Screening for emotional distress is recommended in this population. Use of the tool kit could be an effective postsurgical management strategy for women with gynecologic cancers.