4.6 Article

Changes in symptom clusters in patients undergoing radiation therapy

Journal

SUPPORTIVE CARE IN CANCER
Volume 17, Issue 11, Pages 1383-1391

Publisher

SPRINGER
DOI: 10.1007/s00520-009-0595-5

Keywords

Symptom clusters; Exploratory factor analysis; Breast cancer; Prostate cancer; Radiation therapy; Sickness behavior

Funding

  1. National Cancer Institute
  2. National Institute of Nursing Research (NINR) [NR07088]
  3. National Institutes of Health Roadmap for Medical Research [8 K12 RR023262]

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The goals of the study were to determine the occurrence rates for and the severity of symptoms at the middle, end, and 1 month after the completion of radiation therapy (RT), to determine the number and types of symptom clusters at these three time points, and to evaluate for changes over time in these symptom clusters. Symptom occurrence and severity were evaluated using the Memorial Symptom Assessment Scale (MSAS) in a sample of patients (n = 160) who underwent RT for breast or prostate cancer. At each time point, an exploratory factor analysis was done to determine the number of symptom clusters (i.e., symptom factors) based on the MSAS symptom severity ratings. The majority of the patients were male and married with a mean age of 61.1 years. The five symptoms with the highest occurrence rates across all three time points were lack of energy, pain, difficulty sleeping, feeling drowsy, and sweats. Although the number of symptoms and the specific symptoms within each symptom cluster were not identical across the three time points, three relatively similar symptom clusters (i.e., mood-cognitive symptom cluster, sickness-behavior symptom cluster, treatment-related, or pain symptom cluster) were identified in this sample. The internal consistency coefficients for the mood-cognitive symptom cluster and sickness-behavior symptom cluster were adequate at a parts per thousand yen0.68. Three relatively stable symptom clusters were found across RT. The majority of the symptom cluster severity scores were significantly higher in patients with breast cancer compared to patients with prostate cancer.

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