Symptom clusters in patients receiving chemotherapy: A systematic review

2021 ◽  
pp. bmjspcare-2021-003325
Author(s):  
Carolyn S. Harris ◽  
Kord M. Kober ◽  
Yvette P. Conley ◽  
Anand A. Dhruva ◽  
Marilyn J. Hammer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adjuvant Chemotherapy ◽  
De Novo ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Symptom Cluster ◽  
Registration Number ◽  
Secondary Outcomes ◽  
Symptom Assessment Scale ◽  
Methodological Considerations

Background and purposeSince 2001, symptom cluster research has grown considerably. However, because multiple methodological considerations remain, ongoing synthesis of the literature is needed to identify gaps in this area of symptom science. This systematic review evaluated the progress in symptom clusters research in adults receiving primary or adjuvant chemotherapy since 2016.MethodsEligible studies were published in English between 1 January 2017 and 17 May 2021; evaluated for and identified symptom clusters ‘de novo;’ and included only adults being treated with primary or adjuvant chemotherapy. Studies were excluded if patients had advanced cancer or were receiving palliative chemotherapy; symptoms were measured after treatment; symptom clusters were pre-specified or a patient-centred analytic approach was used. For each study, symptom instrument(s); statistical methods and symptom dimension(s) used to create the clusters; whether symptoms were allowed to load on more than one factor; method used to assess for stability of symptom clusters and associations with secondary outcomes and biomarkers were extracted.ResultsTwenty-three studies were included. Memorial Symptom Assessment Scale was the most common instrument and exploratory factor analysis was the most common statistical method used to identify symptom clusters. Psychological, gastrointestinal, and nutritional clusters were the most commonly identified clusters. Only the psychological cluster remained relatively stable over time. Only five studies evaluated for secondary outcomes.DiscussionWhile symptom cluster research has evolved, clear criteria to evaluate the stability of symptom clusters and standardised nomenclature for naming clusters are needed. Additional research is needed to evaluate the biological mechanism(s) for symptom clusters.PROSPERO registration numberCRD42021240216.

scholarly journals Symptoms and symptom clusters in adolescents with cancer

2021 ◽  
Vol 5 (2) ◽  
pp. 14-24
Author(s):  
Remziye Semerci ◽  
Melahat Akgunmela Kostak ◽  
Tuba Eren ◽  
Filiz Savran ◽  
Gulcan Avci
Keyword(s):  
Symptom Assessment ◽  
Paediatric Oncology ◽  
Symptom Clusters ◽  
Emotional Symptoms ◽  
Purposeful Sampling ◽  
Memorial Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Cancer Experience ◽  
Oncology Unit ◽  
Adolescent Inpatients

Abstract Clinical specialists have suggested that adolescents with cancer experience multiple problems including physical, psychological, and emotional symptoms. This study aimed to identify symptoms and symptoms clusters among adolescent inpatients and outpatients receiving cancer treatment. The study’s sample consisted of 26 adolescents who were selected with the purposeful sampling method in a paediatric oncology unit in Edirne, Turkey. Data were collected using the Memorial Symptom Assessment Scale (MSAS). From the results of the research, in terms of symptoms, outpatients reported a greater lack of concentration than inpatients did. Inpatients reported more hair loss and weight loss symptoms than outpatients. Adolescent inpatients and outpatients experienced the most symptoms during the treatment. Inpatient adolescents experienced more acute treatment-related symptoms than did outpatients. The study recommends regular monitoring and screening for nurses to identify symptom and symptom clusters. Keywords: Adolescent; nursing; symptom cluster; symptom assessment; cancer;  

Symptom clustering among patients visiting a supportive oncology clinic.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 188-188 ◽  
Author(s):  
Kathryn C. Wrammert ◽  
Gwendolynn Harrell ◽  
Michael O'Neill ◽  
Anjali Grandhige ◽  
Danielle Moulia ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Hierarchical Cluster ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Cancer Symptoms ◽  
Patients With Cancer ◽  
Memorial Symptom Assessment Scale ◽  
Supportive Oncology ◽  
Symptom Assessment Scale ◽  
Absolute Correlation

188 Background: Multiple symptoms are common and often severe in patients with cancer. Identification of symptoms which cluster may serve to elucidate the pathophysiology of the disease and aid in symptom management. Our aim was to define symptom clusters occurring among cancer outpatients receiving chemotherapy. Methods: New and returning patients referred to a supportive oncology clinic (SOC) from our health system’s oncologists from November 2011 through May 2014 completed the Condensed Memorial Symptom Assessment Scale plus a sexual dysfunction structured assessment. Data were collected prospectively from 323 consecutive initial visits. Patients rated from 0-4 how bothersome 15 cancer symptoms were; symptoms were then graded as present (1+) or absent (0). Hierarchical cluster analysis with average linkage was used to identify symptom clusters. The absolute value of the correlation between symptoms was used as the measure of similarity between pairs of symptoms. A correlation of ≥0.6 was used to define the final clusters. A symptom cluster was defined as two or more symptoms that predictably occur together. Results: Three clusters were identified: 1. Psychological (worrying, feeling sad, feeling nervous); 2. Treatment-related (lack of energy, feeling drowsy, difficulty concentrating, dry mouth, constipation); 3. Gastrointestinal (weight loss, lack of appetite, nausea). Pain, difficulty sleeping, shortness of breath, and loss of interest did not cluster with any symptom. Gastrointestinal symptoms are important within the clusters. The prevalence of worrying, feeling sad, and feeling nervous did not cluster with lack of energy or difficulty in sleeping, nor pain with worrying or feeling sad. Conclusions: Three symptom clusters were identified as showing high absolute correlation: a psychological cluster, treatment-related cluster, and gastrointestinal cluster. Identifying symptom clusters may promote our understanding of the pathophysiology of cancer, help prioritize effective pharmacotherapies, and identify drugs likely to help more than one symptom.

scholarly journals A modified Edmonton Symptom Assessment Scale for symptom clusters in radiation oncology patients

2017 ◽  
Vol 6 (9) ◽  
pp. 2034-2041 ◽  
Author(s):  
Peter A. S. Johnstone ◽  
Jae Lee ◽  
Jun-Min Zhou ◽  
Zhenjun Ma ◽  
Diane Portman ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Assessment Scale ◽  
Oncology Patients ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale

scholarly journals Identifying Symptom Clusters Among Pregnant Women During Early and Late Pregnancy

2021 ◽  
Author(s):  
Yunxue Zhang ◽  
Xiaofang Xu ◽  
Zihui Xie ◽  
Yuanyuan Li ◽  
Di Zhao ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Late Pregnancy ◽  
Symptom Assessment ◽  
Optimal Number ◽  
Symptom Clusters ◽  
Symptom Cluster ◽  
Dry Mouth ◽  
Convenience Sample ◽  
Psychosomatic Symptoms

Abstract Objectives Symptom assessment and management among women in early and late pregnancy remains concerned, in consideration of multiple co-occurring symptoms; however, evaluation of multidimensional nature of symptom experience (e.g., frequency, severity and distress) and relevant symptom cluster among them is insufficient. To shed light on this understudied field, our study investigated the status of multiple psychosomatic symptoms among women and identified symptom clusters in different gestational stages. Methods A convenience sample of 557 pregnant women were recruited at two tertiary hospitals in Shandong, China. They were asked to complete the Memorial Symptom Assessment Scale, and sociodemographic and clinical information. Spearman correlation analysis, partial correlation networks, and hierarchical cluster analysis were carried out to identify optimal number of symptom clusters. Results Top five scores for symptoms in early pregnancy were nausea, lack of appetite, feeling drowsy, lack of energy, and vomiting; and weight gain, difficulty sleeping, sweating, lack of energy, and dry mouth scored highly in late pregnancy. Four clusters (pregnancy reaction symptom cluster, mood-fatigue symptom cluster, change in libido and food taste symptom cluster, and dry mouth-bloating symptom cluster) were identified in early pregnancy, and three clusters (mood-fatigue symptom cluster, sleep-bloating symptom cluster, and fluid deficiency symptom cluster) were determined in late pregnancy. Conclusion Women experience multiple psychosomatic symptoms during pregnancy, and the manifestation of symptoms varies in different stages. Our study has provided new insights into symptom clusters of pregnant women. These results might potentially support the development of assessment and management of multiple co-occurring symptoms in this population.

Stability of symptom clusters in patients with gastrointestinal cancers receiving chemotherapy.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 193-193
Author(s):  
Claire J. Han ◽  
Kerryn Reding ◽  
Bruce A. Cooper ◽  
Steven M. Paul ◽  
Yvette Conley ◽  
...  
Keyword(s):  
Weight Change ◽  
Management Strategies ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Symptom Dimensions ◽  
Memorial Symptom Assessment Scale ◽  
Exploratory Factor Analyses ◽  
Gi Cancers ◽  
Symptom Assessment Scale ◽  
Over Time

193 Background: Patients with gastrointestinal (GI) cancers who undergo chemotherapy (CTX) experience on average of thirteen symptoms. These co-occurring symptoms often cluster together and can influence various patient outcomes including quality of life (QOL). However, little evidence is available on how these symptoms change during a cycle of chemotherapy (CTX). An evaluation of how these symptom cluster together and how these symptom clusters change over time may provide useful information to guide symptom management strategies tailored to multiple symptoms. Objectives: The purpose of this study was to identify and compare symptom clusters using three symptom dimensions (i.e., occurrence, severity, and distress) at different time points during CTX (i.e., prior to CTX [T1], one week after CTX administration [T2], and two weeks after CTX administration [T3]) in patients with GI cancers. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms. Exploratory factor analyses were used to create the symptom clusters. Results: Five distinct symptom clusters were identified across the three symptom dimensions and the three assessments (i.e., psychological, CTX-related, weight change, GI, and epithelial). Psychological, CTX-related and weight change clusters were relatively stable for all three symptom dimensions as well as across time. GI cluster was identified only at T1, while epithelial cluster was identified at T2 and T3 for all three symptom dimensions. Conclusions: The number and types of symptom clusters appear to be relatively stable over time and across the symptom dimensions. Timely management of symptom clusters should be continued over the course of CTX including the recovery phases. Further studies are needed to explore the mechanisms of symptom clusters in patients with GI cancers undergoing CTX.

Validation of a German version of the NMSS (Non-Motor Symptom assessment Scale)

2010 ◽  
Vol 41 (01) ◽  
Author(s):  
W Jost ◽  
G Fuchs ◽  
G Reifschneider ◽  
P Odin ◽  
A Storch ◽  
...  
Keyword(s):  
Symptom Assessment ◽  
Assessment Scale ◽  
Motor Symptom ◽  
German Version ◽  
Symptom Assessment Scale
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