Cancer-related symptom clusters for symptom management in outpatients after commencing adjuvant chemotherapy, at 6 months, and 12 months

Skerman, Helen; Yates, Patsy; Battistutta, Diana

doi:10.1007/s00520-010-1070-z

Cited by 54 publications

(58 citation statements)

References 35 publications

(49 reference statements)

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“…Sleep disturbance and insomnia were not included in the cluster configuration, as they were rarely abstracted from patients’ charts (but likely were significant issues for hospitalized patients). Skerman and colleagues 54 reported the association of sleep, fatigue, and pain. However, no psychosocial variables were evaluated in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Feelings of sadness or depression was one of numerous psychosocial variables included in some studies, 5, 53 was listed as “psychological distress” in others, 8, 55 and was not evaluated in another. 54 In addition, psychological symptoms have many different connotations which vary considerably based on the verbiage chosen for particular symptom checklists. Likewise, the clustering of pain varied among these studies.…”

Section: Discussionmentioning

confidence: 99%

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Symptom Cluster Analyses Based on Symptom Occurrence and Severity Ratings Among Pediatric Oncology Patients During Myelosuppressive Chemotherapy

Baggott¹,

Cooper²,

Marina³

et al. 2012

Cancer Nursing

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Background Symptom cluster research is an emerging field in symptom management. The ability to identify symptom clusters that are specific to pediatric oncology patients may lead to improved understanding of symptoms’ underlying mechanisms among patients of all ages. Objective The purpose of this study, in a sample of children and adolescents with cancer who underwent a cycle of myelosuppressive chemotherapy, was to compare the number and types of symptom clusters identified using patients’ ratings of symptom occurrence and symptom severity. Interventions/Methods Children and adolescents with cancer (10 to 18 years of age; N=131) completed the Memorial Symptom Assessment Scale 10–18 on the day they started a cycle of myelosuppressive chemotherapy, using a one week recall of experiences. Symptom data based on occurrence and severity ratings were examined using Exploratory Factor Analysis (EFA). The defined measurement model suggested by the best EFA model was then examined with a latent variable analysis. Results Three clusters were identified when symptom occurrence ratings were evaluated which were classified as a chemotherapy sequelae cluster, mood disturbance cluster, and a neuropsychological discomforts cluster. Analysis of symptom severity ratings yielded similar cluster configurations. Conclusions Cluster configurations remained relatively stable between symptom occurrence and severity ratings. The evaluation of patients at a common point in the chemotherapy cycle may have contributed to these findings. Implications for Practice Additional uniformity in symptom clusters investigations is needed to allow appropriate comparisons among studies. The dissemination of symptom clusters research methodology through publication and presentation may promote uniformity in this field.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Symptom Cluster Analyses Based on Symptom Occurrence and Severity Ratings Among Pediatric Oncology Patients During Myelosuppressive Chemotherapy

Baggott¹,

Cooper²,

Marina³

et al. 2012

Cancer Nursing

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show abstract

“…For example, using qualitative research methods (34)(35)(36)(37), several groups of interlinked symptoms were identified de novo through interviews with oncology patients. In several quantitative studies (38)(39)(40)(41)(42), a variety of statistical approaches (eg, factor analysis [FA], hierarchical cluster analysis [HCA], principal components analysis [PCA]) were used to identify symptom clusters de novo. The outcome of these types of analyses is the de novo identification of one or more symptom clusters, each of which contains two or more symptoms.…”

Section: Identification Of Symptom Clustersmentioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

328

330

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An overview of proceedings, findings, and recommendations from the workshop on "Advancing Symptom Science Through Symptom Cluster Research" sponsored by the National Institute of Nursing Research (NINR) and the Office of Rare Diseases Research, National Center for Advancing Translational Sciences, is presented. This workshop engaged an expert panel in an evidenced-based discussion regarding the state of the science of symptom clusters in chronic conditions including cancer and other rare diseases. An interdisciplinary working group from the extramural research community representing nursing, medicine, oncology, psychology, and bioinformatics was convened at the National Institutes of Health. Based on expertise, members were divided into teams to address key areas: defining characteristics of symptom clusters, priority symptom clusters and underlying mechanisms, measurement issues, targeted interventions, and new analytic strategies. For each area, the evidence was synthesized, limitations and gaps identified, and recommendations for future research delineated. The majority of findings in each area were from studies of oncology patients. However, increasing evidence suggests that symptom clusters occur in patients with other chronic conditions (eg, pulmonary, cardiac, and end-stage renal disease). Nonetheless, symptom cluster research is extremely limited and scientists are just beginning to understand how to investigate symptom clusters by developing frameworks and new methods and approaches. With a focus on personalized care, an understanding of individual susceptibility to symptoms and whether a "driving" symptom exists that triggers other symptoms in the cluster is needed. Also, research aimed at identifying the mechanisms that underlie symptom clusters is essential to developing targeted interventions.Patients with chronic conditions, such as cancer and other rare diseases, experience an array of multiple co-occurring symptoms (eg, pain, fatigue, sleep disturbance). When these symptoms remain underdiagnosed and undertreated, they have a negative impact on patient-reported outcomes (PROs) including functional performance, cognitive status, and quality of life (QOL). A reduction in symptom burden in these patients has the potential to improve their capacity to live well over their entire lives. To achieve this goal, a transformation is needed in how multiple co-occurring symptoms are assessed and managed in order to improve patient outcomes and stimulate a reduction in health care utilization and costs. A strategic plan that advances REVIEW

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“…Yet the objective in this study was to consider multi-symptoms instead of single-symptom burden. Previous research has shown that multiple symptoms (some of them in clusters) may be experienced by the majority of patients receiving chemotherapy (Thomas et al, 2014;Skerman et al, 2012), and it was this cumulative effect of multiple symptoms on anxiety levels that we wished to investigate here. Investigation of the links between single chemotherapy-related symptoms and state/trait anxiety levels is nevertheless warranted.…”

Section: Limitations and Future Researchmentioning

confidence: 99%

Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer: Results from a longitudinal study

Schneider

Kotronoulas

Papadopoulou

et al. 2016

European Journal of Oncology Nursing

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Cancer-related symptom clusters for symptom management in outpatients after commencing adjuvant chemotherapy, at 6 months, and 12 months

Cited by 54 publications

References 35 publications

Symptom Cluster Analyses Based on Symptom Occurrence and Severity Ratings Among Pediatric Oncology Patients During Myelosuppressive Chemotherapy

Symptom Cluster Analyses Based on Symptom Occurrence and Severity Ratings Among Pediatric Oncology Patients During Myelosuppressive Chemotherapy

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer: Results from a longitudinal study

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