Symptom clusters change over time among patients with gynecological cancer receiving chemotherapy

Purpose: This study aimed to explore symptom clusters at different time points among patients with gynecological cancer undergoing chemotherapy.Methods: A longitudinal design was used to explore the patterns of symptom clusters four times: during pre -chemotherapy (T0), first (T1), second (T2), and third (T3) cycles of chemotherapy. The Memorial Symptom Assessment Scale was used to assess the dimension of symptoms. The study was conducted in Indonesia. Exploratory factor analysis was used to analyze the structures of symptom clusters across time.Results: A total of 120 subjects provided baseline data, and 82 were retained at T3. Before chemotherapy, the most prevalent symptoms were pain and difficulty in sleeping. However, after starting chemotherapy, the pa-tients suffered from chemotherapy-related side effects, including nausea, change in taste, lack of appetite, hair loss, fatigue, and feeling of I don't look like myself. Six symptom clusters were identified in patients with gynecological cancer across four time points during chemotherapy: pain-related, nutritional, emotional, hormonal-related, fatigue-related, and body-image symptom clusters. Nutrition and emotion symptom clusters occurred consistently from T0 to T3, fatigue-related clusters appeared after chemotherapy at T1 and T2, and body-image symptom clusters emerged at late T2 and T3.Conclusion: The structures of symptom clusters in this study were dynamic and various. The nutrition and emotional-related symptoms constituted a cluster during chemotherapy. Oncology nurses should provide physical and psychosocial interventions to relieve these symptoms in patients with gynecological cancer un-dergoing chemotherapy.

Automated summary

This study aimed to explore symptom clusters at different time points among gynecological cancer patients undergoing chemotherapy. Six symptom clusters were identified, including pain-related, nutritional, emotional, hormonal-related, fatigue-related, and body-image symptom clusters. Nutrition and emotion symptoms consistently occurred during chemotherapy, while fatigue-related symptoms appeared after chemotherapy and body-image symptoms emerged later in the treatment.