Patterns of Symptoms in Women After Gynecologic Surgery

Shan Liu, Elizabeth Ercolano, Mary Lou Siefert, Ruth McCorkle
In: Oncology Nursing Forum · 2010 · vol. 37(2) , pp. E133–E140 · doi:10.1188/10.onf.e133-e140 · PMID:20189912 · W1983878001
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study identified two distinct symptom patterns in women undergoing gynecologic cancer surgery: one that decreased over time (pain, sleep disturbance, nausea) and another that remained constant (fatigue, anxiety, hair loss).

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This study used secondary analysis of longitudinal data from 66 women with gynecologic cancers at a hospital in the northeastern United States who were postsurgical and scheduled for chemotherapy, examining how 10 symptoms changed over time in relation to demographic/clinical factors such as cancer site, stage, treatment, comorbidities, emotional distress, and symptom-management tool kit use. Using descriptive and general estimating equation methods, the researchers identified two symptom trajectories: one set of symptoms (pain, bowel dysfunction, disturbed sleep, depression, nausea, and lack of appetite) decreased over time while another set (fatigue, anxiety, hair loss, and numbness) remained constant, with total symptom burden decreasing overall. Emotional distress and tool kit use were among factors associated with symptom patterns, and the paper discusses possible explanations for the two trajectories, while acknowledging that the analysis is a subset of a larger nursing intervention study. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

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.
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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. Access to this article is restricted. Please log in to view the full article. Explore the benefits of membership.

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