Stability of Symptom Clusters in Patients With Breast Cancer Receiving Chemotherapy

Sullivan, Carmen Ward; Leutwyler, Heather; Dunn, Laura B.; Cooper, Bruce A.; Paul, Steven M.; Levine, Jon D.; Hammer, Marilyn J.; Conley, Yvette P.; Miaskowski, Christine

doi:10.1016/j.jpainsymman.2017.08.008

Cited by 68 publications

(123 citation statements)

References 59 publications

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“…As a result, although some symptom clusters (e.g., psychological) are common across the course of cancer treatment, others are unique to specific treatments and/or cancer diagnoses. 37,38 Despite the overall stability, our findings suggest that variability existed within each symptom cluster. Among the four identified clusters, the uremic symptom cluster accounted for the highest level of variability.…”

Section: Changes In Symptom Clustersmentioning

confidence: 56%

Stability and Impact of Symptom Clusters in Patients With End-Stage Renal Disease Undergoing Dialysis

Ng¹,

So²,

Wong³

et al. 2020

Journal of Pain and Symptom Management

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Section: Changes In Symptom Clustersmentioning

confidence: 56%

Stability and Impact of Symptom Clusters in Patients With End-Stage Renal Disease Undergoing Dialysis

Ng¹,

So²,

Wong³

et al. 2020

Journal of Pain and Symptom Management

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“…No study has identified these symptom clusters prior to AI therapy; however, these symptom clusters have been identified at different assessment timepoints. Sullivan et al () identified the same vasomotor symptom cluster, consisting of hot flashes and night sweats, among women with breast cancer one week before chemotherapy. Vasomotor symptoms (i.e.…”

Section: Discussionmentioning

confidence: 97%

“…In this study, the severity of 10 symptoms (i.e., forgetfulness, easily distracted, weight gain, numbness, decreased appetite, nausea, diarrhoea, swelling of hands or feet, blind spots, dizziness) were significantly higher in the ChemoAnast group than women in the AnastOnly group ( p < .001). Most of these symptoms, such as decreased appetite, nausea, diarrhoea and difficulty breathing, have been reported among women with breast cancer during chemotherapy (Hsu et al, ; Sullivan et al, ). Our results add to the evidence that chemotherapy may exacerbate the severity of some symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…To define a symptom cluster, at least two symptoms must have loaded together, with the Cronbach's ⍺ of the symptoms loading on the symptom cluster being >0.60, and the correlation between the individual symptom and the symptom cluster >0.25 (Ferketich, 1991). To compare the number and type of symptom clusters between two subgroups, we used the criteria demonstrated by Kirkova and Walsh (Kirkova & Walsh, 2007) and Sullivan et al(2018). To conclude that both groups showed the same type of symptom cluster, 'at least 75% of the symptoms within a cluster should be present, including the most prominent or important symptom' (Kirkova & Walsh, 2007, p.1012.…”

Section: Discussionmentioning

confidence: 99%

“…Most symptom cluster studies have evaluated symptom clusters during the short time treatment period (i.e. chemotherapy or radiation therapy) among women with breast cancer (Albusoul, Berger, Gay, Janson, & Lee, 2017;Hsu et al, 2017;Sullivan et al, 2018). To date, few studies have evaluated symptom clusters prior to AI therapy.…”

Section: Introductionmentioning

confidence: 99%

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Impact of chemotherapy on symptoms and symptom clusters in postmenopausal women with breast cancer prior to aromatase inhibitor therapy

Sereika

Marsland

et al. 2019

Journal of Clinical Nursing

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Aims and Objectives To examine and compare the differences in symptoms and symptom clusters between postmenopausal women with early‐stage breast cancer who did and did not receive chemotherapy prior to aromatase inhibitor (AI) therapy. Background Women with breast cancer often experience multiple concurrent symptoms during AI therapy. The burden of symptoms prior to AI is associated with nonadherence to cancer treatment. To date, few studies have comprehensively explored the symptoms and symptom clusters occurring prior to AI therapy. Design Secondary analysis of a prospective repeated‐measures study. Methods The sample comprised postmenopausal women (N = 339) with breast cancer who would receive AI therapy with or without chemotherapy. We collected information on 48 symptoms after surgery or chemotherapy but before AI therapy using different symptom assessment tools. Mann–Whitney U tests were used to compare the differences in the severity of symptoms between groups. Exploratory factor analysis (EFA) was conducted to determine symptom clusters. This study followed STROBE guidelines. Results The most severe symptoms among women with breast cancer prior to AI therapy were breast sensitivity, unhappy with the appearance of my body, general aches and pain, joint pain and muscle stiffness. Women who received chemotherapy prior to AI therapy experienced significantly higher severity of 22 symptoms than women who did not receive chemotherapy. Through EFA seven distinct symptom clusters were revealed in both groups: cognitive, musculoskeletal, psychological, vasomotor, weight, sexual and urinary, with additional gastrointestinal symptom cluster been identified in women who received chemotherapy. Conclusions This study indicates the presence of symptoms among women with breast cancer prior to AI therapy, with higher severity of symptoms and greater number of symptom clusters for women who received chemotherapy. Relevance to clinical practice Nurses should assess and be aware of symptoms and symptom clusters existed prior to AI therapy and manage them in advance.

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Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review

Law

et al. 2021

Cancer Medicine

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Breast cancer patients often experience symptoms that adversely affect their quality of life. It is understood that many of these symptoms tend to cluster together: while they might have different manifestations and occur during different phases of the disease trajectory, the symptoms often have a common aetiology that is a potential target for intervention. Understanding the symptom clusters associated with breast cancer might usefully inform the development of effective care plans for affected patients. The aim of this paper is to provide an updated systematic review of the known symptom clusters among breast cancer patients during and/or after cancer treatment. A search was conducted using five databases for studies reporting symptom clusters among breast cancer patients. The search yielded 32 studies for inclusion. The findings suggest that fatigue‐sleep disturbance and psychological symptom cluster (including anxiety, depression, nervousness, irritability, sadness, worry) are the most commonly‐reported symptom clusters among breast cancer patients. Further, the composition of symptom clusters tends to change across various stages of cancer treatment. While this review identified some commonalities, the different methodologies used to identify symptom clusters resulted in inconsistencies in symptom cluster identification. It would be useful if future studies could separately examine the symptom clusters that occur in breast cancer patients undergoing a particular treatment type, and use standardised instruments across studies to assess symptoms. The review concludes that further studies could usefully determine the biological pathways associated with various symptom clusters, which would inform the development of effective and efficient symptom management strategies.

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Stability of Symptom Clusters in Patients With Breast Cancer Receiving Chemotherapy

Abstract: These findings provide insights into the most common symptom clusters in patients undergoing CTX for breast cancer. In addition, the most common symptoms within each cluster appear to be relatively stable across the two dimensions, as well as across time.

Cited by 68 publications

References 59 publications

Stability and Impact of Symptom Clusters in Patients With End-Stage Renal Disease Undergoing Dialysis

Stability and Impact of Symptom Clusters in Patients With End-Stage Renal Disease Undergoing Dialysis

Impact of chemotherapy on symptoms and symptom clusters in postmenopausal women with breast cancer prior to aromatase inhibitor therapy

Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review

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