Differences in symptom clusters identified using symptom occurrence rates versus severity ratings in patients with breast cancer undergoing chemotherapy
- PMID: 28478849
- PMCID: PMC5494962
- DOI: 10.1016/j.ejon.2017.04.001
Differences in symptom clusters identified using symptom occurrence rates versus severity ratings in patients with breast cancer undergoing chemotherapy
Abstract
Purpose: One of the unanswered questions in symptom clusters research is whether the number and types of symptom clusters vary based on the dimension of the symptom experience used to create the clusters. Given that patients with breast cancer receiving chemotherapy (CTX), report between 10 and 32 concurrent symptoms and studies of symptom clusters in these patients are limited, the purpose of this study, in breast cancer patients undergoing CTX (n = 515), was to identify whether the number and types of symptom clusters differed based on whether symptom occurrence rates or symptom severity ratings were used to create the clusters.
Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess for the occurrence and severity of 38 symptoms, one week after the administration of CTX. Exploratory factor analysis was used to extract the symptom clusters.
Results: Both the number and types of symptom clusters were similar using symptom occurrence rates or symptom severity ratings. Five symptom clusters were identified using symptom occurrence rates (i.e., psychological, hormonal, nutritional, gastrointestinal, epithelial). Six symptom clusters (i.e., psychological, hormonal, nutritional, gastrointestinal, epithelial, chemotherapy neuropathy) were identified using symptom severity ratings. Across the two dimensions, the specific symptoms within each of the symptom clusters were similar.
Conclusions: Identification of symptom clusters in patients with breast cancer may be useful in guiding symptom management interventions. Future studies are warranted to determine if symptom clusters remain stable over a cycle of CTX in patients with breast cancer.
Keywords: Breast cancer; Chemotherapy; Exploratory factor analysis; Symptom clusters; Symptom occurrence; Symptom severity; Symptoms.
Copyright © 2017 Elsevier Ltd. All rights reserved.
Conflict of interest statement
The authors have no conflicts of interest to declare.
Similar articles
-
Differences in Symptom Clusters Identified Using Ratings of Symptom Occurrence vs. Severity in Lung Cancer Patients Receiving Chemotherapy.J Pain Symptom Manage. 2017 Aug;54(2):194-203. doi: 10.1016/j.jpainsymman.2017.04.005. Epub 2017 May 19. J Pain Symptom Manage. 2017. PMID: 28533161 Free PMC article.
-
Stability of Symptom Clusters in Patients With Breast Cancer Receiving Chemotherapy.J Pain Symptom Manage. 2018 Jan;55(1):39-55. doi: 10.1016/j.jpainsymman.2017.08.008. Epub 2017 Aug 31. J Pain Symptom Manage. 2018. PMID: 28838866 Free PMC article.
-
Stability of Symptom Clusters in Patients With Lung Cancer Receiving Chemotherapy.J Pain Symptom Manage. 2019 May;57(5):909-922. doi: 10.1016/j.jpainsymman.2019.02.002. Epub 2019 Feb 13. J Pain Symptom Manage. 2019. PMID: 30768960 Free PMC article.
-
A review of the literature on symptom clusters in studies that included oncology patients receiving primary or adjuvant chemotherapy.J Clin Nurs. 2018 Feb;27(3-4):516-545. doi: 10.1111/jocn.14057. Epub 2017 Oct 10. J Clin Nurs. 2018. PMID: 28859255 Free PMC article. Review.
-
Symptom clusters in patients receiving chemotherapy: A systematic review.BMJ Support Palliat Care. 2022 Mar;12(1):10-21. doi: 10.1136/bmjspcare-2021-003325. Epub 2021 Dec 17. BMJ Support Palliat Care. 2022. PMID: 34921000 Free PMC article.
Cited by
-
Symptom clusters in outpatients with cancer using different dimensions of the symptom experience.Support Care Cancer. 2022 Aug;30(8):6889-6899. doi: 10.1007/s00520-022-07125-z. Epub 2022 May 11. Support Care Cancer. 2022. PMID: 35543816 Free PMC article.
-
Stability of Symptom Clusters in Patients With Gynecologic Cancer Receiving Chemotherapy.Cancer Nurs. 2022 Jul-Aug 01;45(4):E706-E718. doi: 10.1097/NCC.0000000000000988. Epub 2021 Sep 23. Cancer Nurs. 2022. PMID: 34560709 Free PMC article.
-
The need for comprehensive sleep disturbances assessment and management in breast cancer care.Sci Rep. 2025 Jul 1;15(1):21235. doi: 10.1038/s41598-025-05315-3. Sci Rep. 2025. PMID: 40596253 Free PMC article.
-
Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer Survivors.JNCI Cancer Spectr. 2018 Nov;2(4):pky064. doi: 10.1093/jncics/pky064. Epub 2019 Jan 16. JNCI Cancer Spectr. 2018. PMID: 30687806 Free PMC article.
-
Stability of Symptom Clusters in Patients With Gastrointestinal Cancers Receiving Chemotherapy.J Pain Symptom Manage. 2019 Dec;58(6):989-1001.e10. doi: 10.1016/j.jpainsymman.2019.07.029. Epub 2019 Aug 9. J Pain Symptom Manage. 2019. PMID: 31404646 Free PMC article.
References
-
- Babor TF, de la Fuente JR, Saunders J, Grant M. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. World Health Organization; Geneva, Switzerland: 1992.
-
- Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. World Health Organization; Geneva, Switzerland: 2001.
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical