Characteristics of Cancer Symptom Clusters Reported through a Patient-Centered Symptom Cluster Assessment.
Kristine L Kwekkeboom, Ann Wieben, Loyda Braithwaite and 5 others
PMID 33926320WHAT IT FOUND
Cancer patients grouped their symptoms differently, and all 37 priority clusters were unique.
Causes, timing, and symptom links varied too, so confirm each patient's priority cluster before managing co-occurring symptoms.
Key findings
01Patients reported 72 distinct symptom clusters, and only nine were duplicated across participants; one duplicated cluster was pain with numbness or tingling, reported by three participants.
02Thirty-seven participants each identified a priority symptom cluster, and all 37 were unique; neuropsychological clusters were most frequent, with 17 priority clusters.
03Higher symptom cluster burden was associated with worse performance status, poorer physical well-being, poorer mental well-being, and poorer quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The final analysis included only 38 patients, and the sample was mostly female, White, and college educated, so the findings may not apply to more diverse patients. The study did not test whether using this assessment improves symptom management or patient outcomes. Symptom clusters, causes, duration, and relationships were reported for the previous seven days, so longer-term patterns may differ. Patients attributed causes to individual symptoms, not to the whole cluster, and these attributions are patient perceptions, not verified mechanisms. The study included only patients who could read and write English and who were able to complete the assessment. All participants had active disease, and 82% were receiving chemotherapy, so findings may not apply to patients in remission or with other treatments. The relationships between cluster characteristics and age, education, function, well-being, and quality of life are preliminary and need confirmation. Two participants were excluded after it was discovered they may not have met eligibility criteria.
Declared interests
The article is listed as supported by NIH extramural and non-U.S. government funding. The supplied text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not read the common pain, fatigue, and sleep reports as evidence that one symptom cluster treatment will work. Each patient's priority cluster, perceived causes, symptom duration, and symptom relationships were different, and this study did not test a management intervention.