TY - JOUR
T1 - Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience
AU - Han, Claire J.
AU - Reding, Kerryn
AU - Cooper, Bruce A.
AU - Paul, Steven M.
AU - Conley, Yvette P.
AU - Hammer, Marilyn
AU - Wright, Fay
AU - Cartwright, Frances
AU - Levine, J. D.
AU - Miaskowski, Christine
N1 - Publisher Copyright:
© 2019 American Academy of Hospice and Palliative Medicine
PY - 2019/8
Y1 - 2019/8
N2 - Context: Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives: The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n = 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results: These patients experienced 13.0 (±7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion: Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.
AB - Context: Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives: The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n = 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results: These patients experienced 13.0 (±7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion: Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.
KW - Symptoms
KW - chemotherapy
KW - exploratory factor analysis
KW - gastrointestinal cancer
KW - symptom clusters
UR - http://www.scopus.com/inward/record.url?scp=85066260006&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2019.04.035
DO - 10.1016/j.jpainsymman.2019.04.035
M3 - Article
C2 - 31077784
AN - SCOPUS:85066260006
SN - 0885-3924
VL - 58
SP - 224
EP - 234
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 2
ER -