Symptom clusters change over time among patients with gynecological cancer receiving chemotherapy. (October 2022)

• Record Type: Journal Article
• Authors: Haryani, ; Hsu, Yu-Yun; Wang, Shan-Tair
• Is Part Of: European journal of oncology nursing. Volume 60(2022)
• Publication Date: 2022-10
• Subjects: Cancer -- Gynecological cancer -- Chemotherapy -- Symptoms -- Symptom cluster; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2022.102193
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: This study aimed to explore symptom clusters at different time points among patients with gynecological cancer undergoing chemotherapy. Methods: A longitudinal design was used to explore the patterns of symptom clusters four times: during prechemotherapy (T0), first (T1), second (T2), and third (T3) cycles of chemotherapy. The Memorial Symptom Assessment Scale was used to assess the dimension of symptoms. The study was conducted in Indonesia. Exploratory factor analysis was used to analyze the structures of symptom clusters across time. Results: A total of 120 subjects provided baseline data, and 82 were retained at T3. Before chemotherapy, the most prevalent symptoms were pain and difficulty in sleeping. However, after starting chemotherapy, the patients suffered from chemotherapy-related side effects, including nausea, change in taste, lack of appetite, hair loss, fatigue, and feeling of "I don't look like myself." Six symptom clusters were identified in patients with gynecological cancer across four time points during chemotherapy: pain-related, nutritional, emotional, hormonal-related, fatigue-related, and body-image symptom clusters. Nutrition and emotion symptom clusters occurred consistently from T0 to T3, fatigue-related clusters appeared after chemotherapy at T1 and T2, and body-image symptom clusters emerged at late T2 and T3. Conclusion: The structures of symptom clusters in this study were dynamic and various. The nutrition and emotional-related symptoms constituted a cluster during chemotherapy. Oncology nurses should provide physical and psychosocial interventions to relieve these symptoms in patients with gynecological cancer undergoing chemotherapy. Highlights: Few studies using longitudinal design have been conducted to examine symptom clusters among patients with gynecological cancer. Therefore, our findings have important contributions to the existing literature in this area. The longitudinal design in this study enables the continuous comparison of symptom clusters across time points during chemotherapy. The core symptoms in the symptom clusters that were identified reflect the stability of symptom clusters, which could contribute to the knowledge of symptom clusters. The findings of this study highlight the fact that patients with gynecological cancer experience symptom clusters after receiving chemotherapy. Assessment of the co-occurrence of symptoms and the prevalence of symptoms is important.