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    This integrative review examined brain tumor symptoms and their relationship to uncertainty. The review identified 21 studies investigating a diverse range of symptoms in brain tumor patients, including fatigue. However, the antecedents and patterns of symptoms were poorly characterized and inconsistent between and within tumor categories. Unpredictable and unstable symptoms across the trajectory of a brain tumor may significantly contribute to patients' illness-related uncertainty. Understanding the broad scope and variable nature of brain tumor symptoms could help nurses develop strategies to reduce anxiety, distress, and improve quality of life for patients who cannot be cured.

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    Pro Quest

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    This integrative review examined brain tumor symptoms and their relationship to uncertainty. The review identified 21 studies investigating a diverse range of symptoms in brain tumor patients, including fatigue. However, the antecedents and patterns of symptoms were poorly characterized and inconsistent between and within tumor categories. Unpredictable and unstable symptoms across the trajectory of a brain tumor may significantly contribute to patients' illness-related uncertainty. Understanding the broad scope and variable nature of brain tumor symptoms could help nurses develop strategies to reduce anxiety, distress, and improve quality of life for patients who cannot be cured.

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    This integrative review examined brain tumor symptoms and their relationship to uncertainty. The review identified 21 studies investigating a diverse range of symptoms in brain tumor patients, including fatigue. However, the antecedents and patterns of symptoms were poorly characterized and inconsistent between and within tumor categories. Unpredictable and unstable symptoms across the trajectory of a brain tumor may significantly contribute to patients' illness-related uncertainty. Understanding the broad scope and variable nature of brain tumor symptoms could help nurses develop strategies to reduce anxiety, distress, and improve quality of life for patients who cannot be cured.

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    21 views1 page

    Pro Quest

    Uploaded by

    Masita Rezky Sari masita Rezky
    This integrative review examined brain tumor symptoms and their relationship to uncertainty. The review identified 21 studies investigating a diverse range of symptoms in brain tumor patients, including fatigue. However, the antecedents and patterns of symptoms were poorly characterized and inconsistent between and within tumor categories. Unpredictable and unstable symptoms across the trajectory of a brain tumor may significantly contribute to patients' illness-related uncertainty. Understanding the broad scope and variable nature of brain tumor symptoms could help nurses develop strategies to reduce anxiety, distress, and improve quality of life for patients who cannot be cured.

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    of 1

    CLINICAL SCHOLARSHIP

    Brain Tumor Symptoms as Antecedents to Uncertainty: An


    Integrative Review
    Jennifer Cahill, MS, RN1, Geri LoBiondo-Wood, PhD, RN, FAAN2, Nancy Bergstrom PhD, RN, FAAN3, & Terri
    Armstrong, PhD, ANP-BC4
    1 Mu, Doctoral Student, Doctoral Program in Nursing, University of Texas, School of Nursing at Houston, Houston, TX
    2 Upsilon, Associate Professor and Director of Nursing Research and Evidence-Based Practice, University of Texas, M.D. Anderson Cancer Center,
    Houston, TX
    3 Zeta Pi, Professor and Director of Aging Research, Center on Aging, University of Texas, School of Nursing at Houston, TX
    4 Zeta Pi, Associate Professor, University of Texas, M.D. Anderson Cancer Center, and Department of Integrative Care, University of Texas, School of
    Nursing at Houston, both in Huston, TX

    Keywords Abstract
    Symptoms, primary brain tumors, metastatic brain
    tumors, uncertainty Purpose: Uncertainty is a common experience within human cancer. For brain tumor
    patients, irregular symptom pattern and presentation may promote uncertainties about
    Correspondence treatment response, prognosis, and life quality. We sought to identify the somatic
    Jennifer Cahill, University of Texas, School of symptom experience associated with primary and secondary brain tumors and the
    Nursing at Houston, 6901 Bertner Ave., Houston,
    potential impact on illness-related uncertainty.
    TX 77030. E-mail: [email protected]
    Methods: An integrative literature search of Medline and the Cumulative Index to
    Accepted March 25, 2012 doi:
    Nursing and Allied Health Literature (CINAHL) was performed. Symptom data were
    10.1111/j.1547-5069.2012.01445.x excerpted into tables and reviewed critically against the broader uncertainty-focused
    oncology literature.
    Results: Twenty-one studies investigated a diverse range of brain tumor symptoms
    that persist through the now-expanding, post-treatment survival. While symptoms
    such as fatigue were common, antecedents and patterns were poorly characterized and
    inconsistent between and within categories of tumor. Conclusions and Implications:
    Symptom investigation is an emerging and rapidly developing area of neuro-
    oncology. The extent to which symptoms are familiar, predictable, and
    understandable can mitigate uncertainty. The unstable nature of symptoms across the
    trajectory of a brain tumor may be a significant corollary to illness-related
    uncertainty.
    Clinical Relevance: Because the majority of brain tumor patients cannot be cured of
    their cancer, understanding the symptom expanse and potential to promote
    uncertainty could inform alternative nursing strategies to reduce anxiety and distress,
    and to preserve life quality where cure is often unattainable.

    Despite significant advances in treatment and survival, there can degrade quality of life (QoL; Lovely, 2004; Lovely,
    remains substantial symptom burden associated with the Miaskowski, & Dodd, 1999). These symptoms are important
    diagnosis of a brain tumor. Subtle neurologic disability is to balance against absolute survival and other clinical benefits
    often present, and for advanced disease, major consequences of treatment.
    can include progressive functional impairment, cognitive
    decline, and death. Treatment of a brain tumor is generally
    palliative; surgical tumor debulking, radiotherapy, and Symptoms
    chemotherapy are used alone and in combination to prolong Symptoms and Brain Turmors
    life, decelerate neurologic impairment, and alleviate
    symptoms. However, many therapies consequently elicit The symptom experience for any individual patient is
    severe secondary symptoms that difficult to predict. Primary brain tumors (PBTs) evolve from
    and within central nervous tissue and are thus

    Journal of Nursing Scholarship, 2012; 44:2, 145–155. 145


    2012 Sigma Theta Tau International

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