학술논문

Stability of Symptom Clusters in Patients With Lung Cancer Receiving Chemotherapy
Document Type
article
Source
Journal of Pain and Symptom Management. 57(5)
Subject
Health Services and Systems
Nursing
Health Sciences
Cancer
Lung
Clinical Research
Lung Cancer
Antineoplastic Agents
Cluster Analysis
Factor Analysis
Statistical
Female
Humans
Longitudinal Studies
Lung Neoplasms
Male
Middle Aged
Severity of Illness Index
Syndrome
Time Factors
Symptoms
symptom clusters
lung cancer
chemotherapy
exploratory factor analysis
symptom occurrence
symptom severity
Medical and Health Sciences
Anesthesiology
Biomedical and clinical sciences
Health sciences
Language
Abstract
ContextPatients with lung cancer who undergo chemotherapy (CTX) experience multiple symptoms. Evaluation of how these symptoms cluster together and how these symptom clusters change over time are salient questions in symptom clusters research.ObjectivesThe purposes of this analysis, in a sample of patients with lung cancer (n = 145) who were receiving CTX, were to 1) evaluate for differences in the number and types of symptom clusters at three time points (i.e., before their next cycle of CTX, the week after CTX, and two weeks after CTX) using ratings of symptom occurrence and severity and 2) evaluate for changes in these symptom clusters over time.MethodsAt each assessment, a modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence and severity of 38 symptoms. Exploratory factor analyses were used to extract the symptom clusters.ResultsAcross the two symptom dimensions (i.e., occurrence and severity) and the three assessments, six distinct symptom clusters were identified; however, only three of these clusters (i.e., lung cancer specific, psychological, nutritional) were relatively stable across both dimensions and across time. Two additional clusters varied by time but not by symptom dimension (i.e., epithelial/gastrointestinal and epithelial). A sickness behavior cluster was identified at each assessment with the exception of the week before CTX using only the severity dimension.ConclusionFindings provide insights into the most common symptom clusters in patients with lung cancer undergoing CTX. Most common symptoms within each cluster appear to be relatively stable across the two dimensions, as well as across time.