Similarity and Stability of Symptom Cluster in Severity and Distress among Persons with Chronic Obstructive Pulmonary Disease

Abstract

Abstract : This study aimed to explore symptom clusters in severity and distress dimensions as well as similarity and stability, determined twice at 4-weekly intervals, among Thai persons with chronic obstructive pulmonary disease. The participants (n=250) were purposively selected to complete the Personal Information Form and the Bronchitis Emphysema Symptom Checklist. A Principal Component Analysis with a Varimax rotation was used to investigate symptom clusters in dimensions of severity and distress at Times 1 and 2, and the similarity and stability of clusters were determined with a numerical approach.
The results demonstrated clusters of symptom severity and distress existed both Times 1 and 2. The similarity in symptom clusters between both dimensions revealed six and five clusters, respectively at Times 1 and Time 2 with a replication rate of 75–100%. At Time 1, six similar clusters were: emotional problems, memory function decline, disease-related fatigue, respiration difficulty, sleep alteration, pain and unpleasant sensation, and chest discomfort, whereas the cluster of disease-related fatigue disappeared at Time 2. As for stability, the four core set of symptom severity and distress identified with a replication rate of more than 75%, were; 1) emotional problems, 2) memory function decline, 3) sleep alteration, and 4) pain and unpleasant sensation.
Findings from this study may enable nurses to assess symptoms as clusters in either distress or severity to develop a cost-effective intervention program for persons with COPD experiencing these clusters of symptoms.