A review of the literature on symptom clusters in studies that included oncology patients receiving primary or adjuvant chemotherapy.
Carmen Ward Sullivan, Heather Leutwyler, Laura B Dunn and 1 others
PMID 28859255WHAT IT FOUND
Gastrointestinal, psychological, and sickness behavior symptom clusters were common in cancer patients receiving chemotherapy, sometimes with other treatments, but studies used different instruments and methods, so a fixed cluster definition is not supported.
Key findings
01Gastrointestinal symptom clusters were the most common across 19 studies, but their specific symptoms varied; nausea and vomiting appeared in 10 studies.
02Psychological clusters appeared in 12 studies, with feeling sad, worry, depression, and anxiety as common symptoms.
03Sickness behavior was the third most common cluster, with pain, fatigue, disturbed sleep, drowsiness, and lack of appetite.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The search terms may have missed some studies. The final search may not have captured all publications from 2016. The findings may not apply to children with cancer or to patients receiving palliative or hospice care. Only seven of nineteen studies included patients who received only chemotherapy, so clusters may reflect other treatments or mixed treatment groups. The studies varied in cancer diagnoses, instruments, statistical methods, symptom dimensions, and timing of assessment. Only 42.1% of studies were longitudinal, and 37.5% of those found clusters stable over time.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the common gastrointestinal, psychological, and sickness behavior clusters as a confirmed chemotherapy symptom profile. The studies used different instruments, grouping methods, ways of scoring symptoms, cancer diagnoses, treatments, and timing, so the clusters were not consistent.