Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience

Claire J. Han, Kerryn Reding, Bruce A. Cooper, Steven M. Paul, Yvette P. Conley, Marilyn Hammer, Fay Wright, Frances Cartwright, Jon D. Levine, Christine Miaskowski

Research output: Contribution to journalArticle

Abstract

Context: Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives: The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n = 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results: These patients experienced 13.0 (±7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion: Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
DOIs
StatePublished - Jan 1 2019

Fingerprint

Gastrointestinal Neoplasms
Psychology
Symptom Assessment
Statistical Factor Analysis
Weights and Measures
Drug Therapy
Neoplasms

Keywords

  • chemotherapy
  • exploratory factor analysis
  • gastrointestinal cancer
  • symptom clusters
  • Symptoms

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience. / Han, Claire J.; Reding, Kerryn; Cooper, Bruce A.; Paul, Steven M.; Conley, Yvette P.; Hammer, Marilyn; Wright, Fay; Cartwright, Frances; Levine, Jon D.; Miaskowski, Christine.

In: Journal of Pain and Symptom Management, 01.01.2019.

Research output: Contribution to journalArticle

Han, Claire J. ; Reding, Kerryn ; Cooper, Bruce A. ; Paul, Steven M. ; Conley, Yvette P. ; Hammer, Marilyn ; Wright, Fay ; Cartwright, Frances ; Levine, Jon D. ; Miaskowski, Christine. / Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience. In: Journal of Pain and Symptom Management. 2019.
@article{9881652b1dd144f6946f02177fdbe4a2,
title = "Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience",
abstract = "Context: Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives: The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n = 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results: These patients experienced 13.0 (±7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion: Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.",
keywords = "chemotherapy, exploratory factor analysis, gastrointestinal cancer, symptom clusters, Symptoms",
author = "Han, {Claire J.} and Kerryn Reding and Cooper, {Bruce A.} and Paul, {Steven M.} and Conley, {Yvette P.} and Marilyn Hammer and Fay Wright and Frances Cartwright and Levine, {Jon D.} and Christine Miaskowski",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jpainsymman.2019.04.035",
language = "English (US)",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience

AU - Han, Claire J.

AU - Reding, Kerryn

AU - Cooper, Bruce A.

AU - Paul, Steven M.

AU - Conley, Yvette P.

AU - Hammer, Marilyn

AU - Wright, Fay

AU - Cartwright, Frances

AU - Levine, Jon D.

AU - Miaskowski, Christine

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Context: Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives: The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n = 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results: These patients experienced 13.0 (±7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion: Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.

AB - Context: Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives: The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n = 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods: A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results: These patients experienced 13.0 (±7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion: Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.

KW - chemotherapy

KW - exploratory factor analysis

KW - gastrointestinal cancer

KW - symptom clusters

KW - Symptoms

UR - http://www.scopus.com/inward/record.url?scp=85066260006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066260006&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2019.04.035

DO - 10.1016/j.jpainsymman.2019.04.035

M3 - Article

C2 - 31077784

AN - SCOPUS:85066260006

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

ER -