Symptom Experiences and Symptom Cluster across Dimensions in Thais with Advanced Lung Cancer

Authors

  • Thidarat Khamboon RN, PhD Candidate, Faculty of Nursing, Mahidol University, Thailand
  • Kanaungnit Pongthavornkamol RN, PhD, Associate Professor, Faculty of Nursing, Mahidol University, Thailand
  • Karin Olson RN, PhD, Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
  • Doungrut Wattanakitkrileart RN, DNS, Associate Professor, Faculty of Nursing, Mahidol University, Thailand
  • Chukiat Viwatwongkasem PhD, Associate Professor, Department of Biostatistics, Faculty of Public Health, Mahidol Univesity, Thailand
  • Wirote Lausoontornsiri MD, Director Clinical cancer research, National Cancer Institute of Thailand

Keywords:

Advanced lung cancer, Chemotherapy, Symptom experience, Symptom cluster, Thailand

Abstract

                 This study explores symptom experiences and symptom clusters in persons with advanced lung cancer receiving chemotherapy. Using convenience sampling, 300 Thai participants with advanced lung cancer undergoing chemotherapy were recruited from one university hospital and cancer hospital in Bangkok. Data were collected using two questionnaires: a demographic questionnaire, and the Memorial Symptom Assessment Scale. Descriptive statistics was used to determine symptom experience, and a Principal Component Factor with a Varimax rotation was used to analyze clustering of symptoms.

                The results showed that the participants experienced multiple symptoms simultaneously. Lack of appetite was rated as the most prevalent and severe symptom. A problem with urination was rated as the most frequent symptom and constipation was rated as the most distressing symptom. Five symptom clusters existed in both dimensions of symptom severity and distress. However, the symptoms that loaded in each cluster and the name of the clusters were slightly different. The clusters in severity were ‘Emotional-elimination discomfort’, ‘Anorexia-related’, ‘Treatment-related gastrointestinal and other’, ‘Neurological and body image’, and ‘Respiratory and sleep disturbance’. Clusters in symptom distress were ‘Emotional-elimination discomfort’, ‘Body image’, ‘Anorexia-related’, ‘Treatment-related gastrointestinal and other’, ‘Treatment-related neurological and other’. Future research needs a longitudinal design to identify symptom patterns that might change over time along the disease and treatment trajectory. Our findings could be used to develop an intervention program for managing cluster of symptoms, provided they have an underlying common cause.

References

1. National Cancer Institute of Thailand. Hospital based cancer registry annual reported 2012. [Internet]. 2012. [cited 2014May 13]. Available from http://www.nci.go.th/th/File_download/Nci%20Cancer%20Registry/Hospital-Based%20NCI%202012%20Total.pdf

2. Wang S, Tsai C, Chen B, Lin C, Lin C. Symptom clusters and relationships to symptom interference with daily life in Taiwanese lung cancer patients. J Pain Symptom Manage. 2008 35(3): 258-266.

3. Chan C, Richardson A, Richardson J. A study to assess the existence of the symptom cluster of breathlessness, fatigue and anxiety in patients with advanced lung cancer. Eur J Oncol Nurs. 2005 9(4): 325-333.

4. Cleeland CS, Reyes-Gibby CC. When is it justified to treat symptoms? Measuring symptom burden. Oncology. 2002 16(9): 64-70.

5. Sarna L, Brecht ML. Dimensions of symptom distress in women with advanced lung cancer: a factor analysis. Heart & lung: the journal of critical care. 1997 26(1): 23-30.

6. Miaskowski C, Aouizerat BE, Dodd M, Cooper B. Conceptual issues in symptom clusters research and their implications for quality-of-life assessment in patients with cancer. JNCI Monographs. 2007 37: 39-46.

7. Suwisith N, Hanucharurnkul S, Dodd M, Vorapongsathorn T, Pongthavorakamol K, Asavametha N. Symptom clusters and functional status of women with breast cancer. Pacific Rim Int J of Nurs Res. 2008 12(3):153-165.

8. Phligbua W, Pongthavornkamol K, Knobf T, Junda T, Viwatwongkasem C, Srimuninnimit V. Symptom clusters andquality of life in women with breast cancer receiving adjuvant chemotherapy. Pacific Rim Int J of Nurs Res. 2013 17(3):249-267.

9. Lenz ER, Pugh LC, Milligan RA, Gift A, Suppe F. The middle-range theory of unpleasant symptoms: an update. Adv Nurs Sci. 1997 19(3):14-27.

10. Tishelman C, Degner L, Rudman A, Bertilsson K, Bond R, Broberger E, et al. Symptoms in patients with lung carcinoma. Cancer. 2005 104(9):2013-2021.

11. Fox S, Lyon D. Symptom clusters and quality of life in survivors of lung cancer. Oncol Nurs Forum. 2006 33(5):931-936.

12. Kim H-J, McGuire DB, Tulman L, Barsevick AM. Symptom clusters: concept analysis and clinical implications for cancer nursing. Cancer Nurs. 2005 28(4):270-282.

13. Dodd MJ, Miaskowski C, Paul SM, editors. Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum. 2001 28(3):465-470.

14. Chaiviboontham S, Viwatwongkasem C, Hanucharurnkul S, McCorkle R. Symptom clusters in Thais with advanced cancer. Pacific Rim Int J of Nurs Res. 2013 15(4):265-277.

15. Pudthong N, Aungsuroch Y, Jitpany C. Symptom clusters in Thai patients with advanced lung cancer. J Health Res. 2014 28(3): 183-189.

16. Hair J, Black W, Babin B., & Anderson R. Multivariate data analysis. 7th edition, NJ: Prentice hall Upper Saddle River; 2010.

17. Dixon JK. Exploratory factor analysis. In Munro, BH. Statistical methods for Health Care Research. 5th edition, Philadelphia: Lippincott Willimams & Wilkins; 2005.

18. Williams B, Brown T, Onsman A. Exploratory factor analysis:a five-step guide for novices. Australian J Paramed. 2010 8(3): Article 990399.

19. Portenoy RK, Thaler HT, Kornblith AB, McCarthy Lepore J,Friedlander-Klar H, Kiyasu E, et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Canc. 1994 30(9):1326-1336.

20. Malangpoothong R, Pongthavornkamol K, Sriyuktasuth A, Soparattanapaisarn N. Symptom experiences, management strategies and functional status in advanced lung cancer patients receiving chemotherapy. J NURS SCI. 2009 27(2):69-78.

21. Gift A, Jablonski A, Stommel M, Given CW. Symptom clustersin elderly patients with lung cancer. Oncol Nurs Forum. 2004 31(2):203-212.

22. Molassiotis A, Lowe M, Blackhall F, Lorigan P. A qualitative exploration of a respiratory distress symptom cluster in lung cancer: Cough, breathlessness and fatigue. Lung Cancer. 2010 71(1):94-102.

23. Porter LS, Keefe FJ, Garst J, McBride CM, Baucom D. Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress. Pain. 2008 137(2):306-315.

24. Hoffman AJ. Fatigue, self-efficacy, and physical functional status in persons with lung cancer: Michigan State University. College of Nursing; 2007.

25. Akin S, Can G, Aydiner A, Ozdilli K, Durna Z. Quality of life,symptom experience and distress of lung cancer patients undergoing chemotherapy. Eur J Canc. 2010 14(5): 400-409.

26. Walsh D, Rybicki L. Symptom clustering in advanced cancer. Support Care Cancer. 2006 14(8):831-836.

27. Hoffman A, Given B, Eye A, Gift A, Given C. Relationships among pain, fatigue, insomnia, and gender in persons with lung cancer. Onc Nurs Society. 2007 34(4): 785-792.

28. Kirkova J, Walsh D, Aktas A, Davis MP. Cancer symptom clusters: old concept but new data. Am J Hosp Palliat Care. 2010 27(4):282-288.

29. Fan G, Filipczak L, Chow E. Symptom clusters in cancer patients: a review of the literature. Curr Oncol. 2007 14(5):173-179.

30. Kim E, Jahan T, Aouizerat BE, Dodd MJ, Cooper BA, Paul SM, et al. Differences in symptom clusters identified using occurrence rates versus symptom severity ratings in patients at the end of radiation therapy. Cancer Nurs. 2009 32(6):429-436.

31. Goodell TT, Nail LM, editors. Operationalizing symptom distress in adults with cancer: a literature synthesis. Oncol Nurs Forum. 2005 32(2):E42-E47.

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Published

2015-11-18

How to Cite

1.
Khamboon T, Pongthavornkamol K, Olson K, Wattanakitkrileart D, Viwatwongkasem C, Lausoontornsiri W. Symptom Experiences and Symptom Cluster across Dimensions in Thais with Advanced Lung Cancer. PRIJNR [Internet]. 2015 Nov. 18 [cited 2024 Dec. 19];19(4):330-44. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/31213

Issue

Vol. 19 No. 4 (2015): October-December 2015

Section

Original paper

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Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.