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. 2010 Apr;14(2):101-10.
doi: 10.1016/j.ejon.2009.09.005. Epub 2009 Nov 7.

The effect of symptom clusters on functional status and quality of life in women with breast cancer

Marylin J Dodd  1 , Maria H Cho, Bruce A Cooper, Christine Miaskowski
Affiliations

The effect of symptom clusters on functional status and quality of life in women with breast cancer

Marylin J Dodd et al. Eur J Oncol Nurs. 2010 Apr.

Abstract

Purpose: The purposes of this study of women with breast cancer receiving chemotherapy with/without radiation therapy were to determine whether: (1) subgroups of oncology outpatients can be identified based on a specific symptom cluster (i.e., pain, fatigue, sleep disturbances, depression); (2) these subgroups differ on outcomes (i.e., functional status, quality of life); (3) subgroup membership changes over time.

Methods: A secondary data analysis using data collected from 112 women at initial chemotherapy. Symptom and outcome measures were completed at three time points: baseline (i.e., the week before cycle two - T1); end of cancer treatment (T2), end of the study (approximately one year after the start of chemotherapy - T3). Cluster analysis identified patient subgroups based on symptom severity scores.

Results: At T1 and T2, four patient subgroups were identified: ALL LOW (one or no symptom greater than the cut score), MILD (two symptoms), MODERATE (three or four symptoms), and ALL HIGH (four symptoms). At T3, three subgroups were identified: MILD, MODERATE and ALL HIGH. Subgroups with high severity levels of all four symptoms had poorer functional status and QOL at each time point than other subgroups (p<0.001). Group membership changed over time.

Conclusions: Subgroups of patients with different symptom experiences were identified. For some patients severity of all four symptoms persisted months after cancer treatment. Initial and ongoing assessment to identify those patients in the ALL HIGH patient subgroup is important so that appropriate interventions to improve functional status and quality of life can be offered.

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Conflict of interest statement

Conflict of Interest Statement: None declared.

Figures

Figure 1
Figure 1
Standardized scores for the four symptoms at T1, T2, and T3. All values are plotted as standardized mean scores and their standard deviations.
Figure 2
Figure 2
Changes in functional status scores among patient subgroups at T1, T2, and T3. All values are plotted as mean and standard deviations.
Figure 3
Figure 3
Changes in quality of life scores among patient subgroups at T1, T2 and T3. All values are plotted as mean and standard deviations.
Figure 4
Figure 4
Changes in patient subgroup membership from T1 to T2 and from T2 to T3 formula image Low formula image Mild formula image Moderate formula image High
See this image and copyright information in PMC

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