Cancer symptom clusters: a validation study
- PMID: 17629670
- DOI: 10.1016/j.jpainsymman.2007.01.008
Cancer symptom clusters: a validation study
Abstract
Cancer patients often experience multiple symptoms concurrently, a phenomenon called symptom clustering. Different symptom clusters have been identified by various symptom assessment tools, as well as by different research methods, but no study has reported whether these identified symptom clusters can be replicated in a new sample. The severity of nine symptoms in 321 cancer patients was assessed using a Taiwanese version of the M.D. Anderson Symptom Inventory. The fit between these data and a model with three symptom factors (sickness, gastrointestinal, and emotional) was evaluated using confirmatory factor analysis. Most fitness indices demonstrated a satisfactory fit between the data and a prespecified three-factor model except one; the root mean square error of approximation was <0.06. A modified model with one symptom (lack of appetite) double loaded in the sickness and gastrointestinal factors demonstrated a significantly better fit between the data and the model. Higher scores in each of the three symptom factors were associated with poorer functional status. Metastatic disease and receiving both chemotherapy and radiation therapy were associated with higher scores in sickness and gastrointestinal factors, but not in the emotional factor. Only hospitalization affected patients' scores in emotional factors. Our findings confirmed the prespecified structure of symptom clusters. A modified model showed a better fit. Patients' complex symptom experience may be better represented by subscale scores based on meaningful clusters rather than on an overall score across all symptoms.
Similar articles
-
Chinese version of the M. D. Anderson Symptom Inventory: validation and application of symptom measurement in cancer patients.Cancer. 2004 Oct 15;101(8):1890-901. doi: 10.1002/cncr.20448. Cancer. 2004. PMID: 15386315
-
Symptom clusters and relationships to symptom interference with daily life in Taiwanese lung cancer patients.J Pain Symptom Manage. 2008 Mar;35(3):258-66. doi: 10.1016/j.jpainsymman.2007.03.017. Epub 2008 Jan 16. J Pain Symptom Manage. 2008. PMID: 18201865
-
Taiwanese version of the M. D. Anderson symptom inventory: symptom assessment in cancer patients.J Pain Symptom Manage. 2007 Feb;33(2):180-8. doi: 10.1016/j.jpainsymman.2006.07.018. J Pain Symptom Manage. 2007. PMID: 17280923
-
Assessment of symptom clusters in people with cancer.J Natl Cancer Inst Monogr. 2004;(32):98-102. doi: 10.1093/jncimonographs/lgh009. J Natl Cancer Inst Monogr. 2004. PMID: 15263048 Review.
-
[Symptom clusters in cancer patients].Hu Li Za Zhi. 2008 Apr;55(2):22-8. Hu Li Za Zhi. 2008. PMID: 18393206 Review. Chinese.
Cited by
-
Mindfulness based stress reduction in post-treatment breast cancer patients: an examination of symptoms and symptom clusters.J Behav Med. 2012 Feb;35(1):86-94. doi: 10.1007/s10865-011-9346-4. Epub 2011 Apr 20. J Behav Med. 2012. PMID: 21506018 Clinical Trial.
-
Impact of Multimorbidity on Symptom Burden and Symptom Clusters in Patients Receiving Chemotherapy.Cancer Med. 2025 Feb;14(3):e70418. doi: 10.1002/cam4.70418. Cancer Med. 2025. PMID: 39910913 Free PMC article.
-
Fatigue-based subgroups of breast cancer survivors with insomnia.Cancer Nurs. 2009 Sep-Oct;32(5):404-11. doi: 10.1097/NCC.0b013e3181a5d05e. Cancer Nurs. 2009. PMID: 19661794 Free PMC article.
-
Gastrointestinal Symptom Cluster is Associated With Epigenetic Regulation of Lymphotoxin Beta in Oncology Patients Receiving Chemotherapy.Biol Res Nurs. 2023 Jan;25(1):51-64. doi: 10.1177/10998004221115863. Epub 2022 Aug 5. Biol Res Nurs. 2023. PMID: 35929442 Free PMC article.
-
Symptom clusters and quality of life in older adult breast cancer survivors.Oncol Nurs Forum. 2011 Nov;38(6):672-80. doi: 10.1188/11.ONF.672-680. Oncol Nurs Forum. 2011. PMID: 22037330 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical