Symptom Clusters Change Over Time in Women Receiving Adjuvant Chemotherapy for Breast Cancer

Randa M. Albusoul, Ann Malone Berger, Caryl L. Gay, Susan L. Janson, Kathryn A. Lee

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Context Patients with breast cancer receiving chemotherapy (CTX) experience multiple concurrent symptoms, but little is known about how symptoms change during and after treatment. Knowledge of the identity and trajectory of symptom clusters (SCs) would enhance measurement and management. Objectives We aimed to identify SCs and their change over time from baseline to completion of breast cancer CTX. Methods SCs were identified and assessed for change in 219 women from Nebraska at four times: baseline, during cycles #3 and #4 of CTX, and one month after finishing CTX. Ten symptoms were measured: two using the Hospital Anxiety and Depression Scale and eight using the Symptom Experience Scale. Exploratory factor analysis was conducted at each time point, then changes in SCs were evaluated at different times. Results Two SCs were identified before and after initiating CTX: gastrointestinal and treatment-related. The number and type of symptoms in each cluster differed over time. Clusters were dynamic during CTX with changes in the number and type of symptoms. Only one treatment-related SC, which consisted of fatigue, pain, and sleep disturbance, was identified after CTX completion. Conclusion SCs during CTX appear to be dynamic, changing over time from before until after CTX completion. Repeated assessments of SCs reveal symptoms that are present and when patients are most burdened and in need of additional support.

Original languageEnglish (US)
Pages (from-to)880-886
Number of pages7
JournalJournal of Pain and Symptom Management
Volume53
Issue number5
DOIs
StatePublished - May 2017

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Adjuvant Chemotherapy
Breast Neoplasms
Statistical Factor Analysis
Fatigue
Sleep
Therapeutics
Anxiety
Depression
Drug Therapy
Pain

Keywords

  • Breast cancer
  • chemotherapy
  • longitudinal study
  • oncology
  • symptom clusters
  • symptom experience

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Symptom Clusters Change Over Time in Women Receiving Adjuvant Chemotherapy for Breast Cancer. / Albusoul, Randa M.; Berger, Ann Malone; Gay, Caryl L.; Janson, Susan L.; Lee, Kathryn A.

In: Journal of Pain and Symptom Management, Vol. 53, No. 5, 05.2017, p. 880-886.

Research output: Contribution to journalArticle

Albusoul, Randa M. ; Berger, Ann Malone ; Gay, Caryl L. ; Janson, Susan L. ; Lee, Kathryn A. / Symptom Clusters Change Over Time in Women Receiving Adjuvant Chemotherapy for Breast Cancer. In: Journal of Pain and Symptom Management. 2017 ; Vol. 53, No. 5. pp. 880-886.
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abstract = "Context Patients with breast cancer receiving chemotherapy (CTX) experience multiple concurrent symptoms, but little is known about how symptoms change during and after treatment. Knowledge of the identity and trajectory of symptom clusters (SCs) would enhance measurement and management. Objectives We aimed to identify SCs and their change over time from baseline to completion of breast cancer CTX. Methods SCs were identified and assessed for change in 219 women from Nebraska at four times: baseline, during cycles #3 and #4 of CTX, and one month after finishing CTX. Ten symptoms were measured: two using the Hospital Anxiety and Depression Scale and eight using the Symptom Experience Scale. Exploratory factor analysis was conducted at each time point, then changes in SCs were evaluated at different times. Results Two SCs were identified before and after initiating CTX: gastrointestinal and treatment-related. The number and type of symptoms in each cluster differed over time. Clusters were dynamic during CTX with changes in the number and type of symptoms. Only one treatment-related SC, which consisted of fatigue, pain, and sleep disturbance, was identified after CTX completion. Conclusion SCs during CTX appear to be dynamic, changing over time from before until after CTX completion. Repeated assessments of SCs reveal symptoms that are present and when patients are most burdened and in need of additional support.",
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