Symptoms and symptom clusters in patients with hepatocellular carcinoma and commonly used instruments: An integrated review.
Thitiporn Pathomjaruwat, Yaowarat Matchim, Jane M Armer
PMID 38352278WHAT IT FOUND
HCC patients commonly report clusters of fatigue, pain, appetite loss, sleep disturbance, distress, and liver-related symptoms.
Nurses should use symptom tools that capture these clusters, not only general cancer symptom lists.
Key findings
01People with hepatocellular carcinoma commonly report clusters of fatigue, pain, appetite loss, sleep disturbance, distress, and liver-related symptoms.
02Symptom prevalence and clusters changed with disease stage and treatment, including after TACE and with lenvatinib.
03Nurses should use symptom assessment tools that match the aim, because general cancer tools may miss HCC-specific symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only five databases were searched, and only papers with English abstracts were included, so relevant studies may have been missed. The included studies were heterogeneous in design, population, stage, and treatment, and symptom clusters varied by instrument, so the review did not produce one pooled estimate. The review describes prevalence and assessment tools; it does not test whether symptom management interventions improve outcomes. Some included studies used caregiver or clinical examination reports, which may differ from patient self-report.
Declared interests
This work was supported by the Research Unit in Palliative Care for Adults and Older Adults, Faculty of Nursing, Thammasat University, Thailand, and the Bualuang ASEAN Chair Professor Fund. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that using a particular symptom instrument or treating one symptom will reduce the whole cluster. The review reports what patients experienced across different studies and instruments, not evidence that a nursing intervention works.