The Correlation of Symptom Clusters and Functional Performance in Adult Acute Leukemia Patients Under Chemotherapy

Abstract

Background Adult acute leukemia (AL) patients who receive chemotherapy usually experience multiple symptoms during the treatment course. The symptom clusters (SCs) as well as subsets of concurrent symptoms in AL patients have not yet been demonstrated. Objective To investigate the SCs of adult AL patients who were receiving chemotherapy and to determine their correlations with functional performance. Methods A total of 132 hospitalized adult AL patients were included in this study. A cross-sectional survey aimed to examine symptoms and functional performance was conducted. The patients’ symptoms were assessed using the Chinese version of the Condensed Memorial Symptom Assessment Scale, and functional performance was evaluated through activities of daily living and quality of life. Results We identified 4 SCs in adult AL patients: psychological SC, pain-fatigue-sleep SC, dry mouth–constipation SC, and nutrition-impaired SC. The psychological SC was the most common and most distressing SC. The different SCs were each differentially correlated with patient characteristics. The distress of the psychological SC, pain-fatigue-sleep SC, and nutrition-impaired SC was adversely correlated with functional performance. Conclusions Adult AL patients undergoing chemotherapy experience multiple symptoms that can be further categorized into 4 SCs. The distress from some SCs is negatively associated with patients’ functional performance. Implications for Practice Symptom burden remains a major problem for adult AL patients undergoing chemotherapy. Identifying SCs of AL patients should be the basis for accurate and cost-effective interventions. Personalized SC management may improve the functional performance and healthcare quality of adult AL patients.

Symptom clusters and quality of life in ambulatory patients with multiple myeloma

“…It might be because elderly patients had better coping strategies due to more life experience than that of young patients. Furthermore, in agree with previous studies, our data suggested that more female patients reported severe symptom distress of psycological SC than the male [7,21]. At last, the distress of psychological SC was in uenced by the patients' treatment outcome.…”

“…The rst SC was psychological SC which included symptoms of feeling nervous, worrying and feeling sad. Although the speci c symptom items might be different in the cluster, psychological SC has been demonstrated as a common SC in patients with cancer, either solid tumor or hematological malignancy [5][6][7]. Speci c psychological symptom in MM had been reported in previous studies [19].…”

“…We conducted a cross-sectional survey to assess the symptoms, and QOL of MM patients who had been admitted in the hematology day unit of West China hospital, Sichuan University, from June 27, 2019 to January 31, 2020. Patients inclusion criteria were: (1) diagnosed with MM, without any other co-existing cancers; (2) age ≥ 18 years old; (3) receiving medication therapy during the survey; (4) not receiving hematopoietic stem cell transplantation or bone marrow transplantation during the survey; (5) estimated length of stay ≤ 24 h; (6) with normal cognitive ability and capable of listening, speaking, reading, and writing; (7) willing to participate in the study. The patients who admitted to the day unit more than one time only participated in this study once.…”

“…Previouse studies have shown that cancer patients often experienced multiple symptoms, and some symptoms could clsuter together as symptom clusters (SCs) [5][6][7]. The symptoms in a SC may share the similar physiological or pathological mechanisms, thus provide ideas for more e cient interventions targeted to SCs [8].…”

Symptom clusters in patients receiving chemotherapy: A systematic review

“…Of the 23 studies included in this review, 13 used a cross-sectional design to identify symptom clusters in oncology patients receiving chemotherapy (online supplemental table 1). Seven studies were conducted in the USA,29 32–37 two in China,38 39 two in Thailand,40 41 one in Austria,42 and one in Turkey 43. Sample sizes ranged from 9641 to 1328 29.…”