Exploring the Relationship Between Health-Illness Transition Experiences and Distress Among Patients With Pancreatic Cancer.
Jessica I Goldberg, Jessica R Flynn, Raymond E Baser and 3 others
PMID 37677764WHAT IT FOUND
Distress stayed high and unchanged over six weeks, but unmanaged transitions decreased.
Higher distress linked directly to greater unmanaged physical, emotional, and cancer status transitions. Nurses should assess distress to identify patients struggling to cope with these changes.
Key findings
01The overall level of distress reported by patients at the two study time points was unchanged (time 1: mean = 4.07, SD = 2.15; time 2: mean = 4.02, SD = 2.04; p > 0.9).
02The presence of unmanaged transitions, as measured by the NFI, significantly decreased between the two time points.
03At both time points, there was a direct relationship between the presence of unmanaged physical, emotional, and cancer status transitions and distress.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small (55 patients) and mostly White, meaning results may not apply to Black patients, who have a higher incidence of pancreatic cancer. Participants were only those receiving chemotherapy, so findings may not apply to patients on immunotherapy or targeted treatments. The follow-up interval of four to six weeks may have been too short for some patients to fully experience or acknowledge transitions. The study was not powered to detect differences in the relationship between unmanaged transitions and distress. The concurrent COVID-19 pandemic may have influenced patients' self-management capacity and interactions with healthcare providers.
Declared interests
The research was supported by the National Institutes of Health (Extramural) and non-U.S. government sources. No other conflicts of interest were declared.
The easy way to misread this
Do not assume that distress levels will naturally improve over time. In this study, distress remained unchanged and high (mean 4.07 to 4.02) even as patients managed transitions better. A lack of improvement in distress scores is a signal to investigate unmanaged transitions, not a sign that the patient is coping well.