Symptom clusters in patients with breast cancer receiving radiation therapy
Symptoms experienced by breast cancer patients often cluster together in groups known as “symptom clusters”. The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT). Edmonton Symptom Assessment Scale (ESAS) scores were taken from bre...
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| Veröffentlicht in: | European journal of oncology nursing : the official journal of European Oncology Nursing Society 2019-10, Vol.42, p.14-20 |
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| container_title | European journal of oncology nursing : the official journal of European Oncology Nursing Society |
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| creator | Chow, Selina Wan, Bo Angela Pidduck, William Zhang, Liying DeAngelis, Carlo Chan, Stephanie Yee, Caitlin Drost, Leah Leung, Eric Sousa, Philomena Lewis, Donna Lam, Henry Chow, Ronald Lock, Michael Chow, Edward |
| description | Symptoms experienced by breast cancer patients often cluster together in groups known as “symptom clusters”. The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT).
Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points.
This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.
Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.
•Symptom clusters (SC) are symptoms experienced together, and are important in quality of life and symptom management.•This study evaluated SD in 1224 metastatic breast cancer patients before, during and after receiving radiotherapy (RT).•Two SC were found before the start of RT, with wellbeing, depression, and anxiety consistently clustered together.•End of RT found clustering of: wellbeing, depression, anxiety; nausea appetite; drowsiness dyspnea.•Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.•Understanding the clustering of symptoms in this population can improve management of symptoms. |
| doi_str_mv | 10.1016/j.ejon.2019.07.004 |
| format | Article |
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Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points.
This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.
Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.
•Symptom clusters (SC) are symptoms experienced together, and are important in quality of life and symptom management.•This study evaluated SD in 1224 metastatic breast cancer patients before, during and after receiving radiotherapy (RT).•Two SC were found before the start of RT, with wellbeing, depression, and anxiety consistently clustered together.•End of RT found clustering of: wellbeing, depression, anxiety; nausea appetite; drowsiness dyspnea.•Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.•Understanding the clustering of symptoms in this population can improve management of symptoms.</description><identifier>ISSN: 1462-3889</identifier><identifier>EISSN: 1532-2122</identifier><identifier>DOI: 10.1016/j.ejon.2019.07.004</identifier><identifier>PMID: 31446259</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Adult ; Aged ; Anxiety - diagnosis ; Anxiety - epidemiology ; Breast cancer ; Breast Neoplasms - complications ; Breast Neoplasms - psychology ; Breast Neoplasms - radiotherapy ; Cancer Pain - diagnosis ; Cancer Pain - epidemiology ; Cluster Analysis ; Depression - diagnosis ; Depression - epidemiology ; Dyspnea - diagnosis ; Dyspnea - epidemiology ; Edmonton symptom assessment system ; Factor Analysis, Statistical ; Fatigue - diagnosis ; Fatigue - epidemiology ; Feeding and Eating Disorders - diagnosis ; Feeding and Eating Disorders - epidemiology ; Female ; Humans ; Middle Aged ; Nausea - diagnosis ; Nausea - epidemiology ; Nursing ; Principal Component Analysis ; Radiotherapy ; Symptom Assessment - methods ; Symptom clusters</subject><ispartof>European journal of oncology nursing : the official journal of European Oncology Nursing Society, 2019-10, Vol.42, p.14-20</ispartof><rights>2019 Elsevier Ltd</rights><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-d42870ffe3cb7ee277cf44d07af1da99bda92b8cfeebdd33e3cef738baf8eac33</citedby><cites>FETCH-LOGICAL-c356t-d42870ffe3cb7ee277cf44d07af1da99bda92b8cfeebdd33e3cef738baf8eac33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejon.2019.07.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31446259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chow, Selina</creatorcontrib><creatorcontrib>Wan, Bo Angela</creatorcontrib><creatorcontrib>Pidduck, William</creatorcontrib><creatorcontrib>Zhang, Liying</creatorcontrib><creatorcontrib>DeAngelis, Carlo</creatorcontrib><creatorcontrib>Chan, Stephanie</creatorcontrib><creatorcontrib>Yee, Caitlin</creatorcontrib><creatorcontrib>Drost, Leah</creatorcontrib><creatorcontrib>Leung, Eric</creatorcontrib><creatorcontrib>Sousa, Philomena</creatorcontrib><creatorcontrib>Lewis, Donna</creatorcontrib><creatorcontrib>Lam, Henry</creatorcontrib><creatorcontrib>Chow, Ronald</creatorcontrib><creatorcontrib>Lock, Michael</creatorcontrib><creatorcontrib>Chow, Edward</creatorcontrib><title>Symptom clusters in patients with breast cancer receiving radiation therapy</title><title>European journal of oncology nursing : the official journal of European Oncology Nursing Society</title><addtitle>Eur J Oncol Nurs</addtitle><description>Symptoms experienced by breast cancer patients often cluster together in groups known as “symptom clusters”. The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT).
Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points.
This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.
Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.
•Symptom clusters (SC) are symptoms experienced together, and are important in quality of life and symptom management.•This study evaluated SD in 1224 metastatic breast cancer patients before, during and after receiving radiotherapy (RT).•Two SC were found before the start of RT, with wellbeing, depression, and anxiety consistently clustered together.•End of RT found clustering of: wellbeing, depression, anxiety; nausea appetite; drowsiness dyspnea.•Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.•Understanding the clustering of symptoms in this population can improve management of symptoms.</description><subject>Adult</subject><subject>Aged</subject><subject>Anxiety - diagnosis</subject><subject>Anxiety - epidemiology</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - psychology</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Cancer Pain - diagnosis</subject><subject>Cancer Pain - epidemiology</subject><subject>Cluster Analysis</subject><subject>Depression - diagnosis</subject><subject>Depression - epidemiology</subject><subject>Dyspnea - diagnosis</subject><subject>Dyspnea - epidemiology</subject><subject>Edmonton symptom assessment system</subject><subject>Factor Analysis, Statistical</subject><subject>Fatigue - diagnosis</subject><subject>Fatigue - epidemiology</subject><subject>Feeding and Eating Disorders - diagnosis</subject><subject>Feeding and Eating Disorders - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Nausea - diagnosis</subject><subject>Nausea - epidemiology</subject><subject>Nursing</subject><subject>Principal Component Analysis</subject><subject>Radiotherapy</subject><subject>Symptom Assessment - methods</subject><subject>Symptom clusters</subject><issn>1462-3889</issn><issn>1532-2122</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlb_gAfJ0cuu-dg2WfAixS8UPKjnkE0mNqX7YZJW-u9NqXr0MjMwz7wwD0LnlJSU0NnVsoRl35WM0LokoiSkOkBjOuWsYJSxwzxXM1ZwKesROolxSQipuZDHaMRplVfTeoyeXrftkPoWm9U6JggR-w4POnnoUsRfPi1wE0DHhI3uDAQcwIDf-O4DB219BvsOpwUEPWxP0ZHTqwhnP32C3u9u3-YPxfPL_eP85rkwfDpLha2YFMQ54KYRAEwI46rKEqEdtbqum1xYI40DaKzlPHPgBJeNdhK04XyCLve5Q-g_1xCTan00sFrpDvp1VIxJMmVyxnYo26Mm9DEGcGoIvtVhqyhRO4lqqXYS1U6iIkJlifno4id_3bRg_05-rWXgeg9A_nLjIahosjAD1mc9Sdne_5f_DY-shfg</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Chow, Selina</creator><creator>Wan, Bo Angela</creator><creator>Pidduck, William</creator><creator>Zhang, Liying</creator><creator>DeAngelis, Carlo</creator><creator>Chan, Stephanie</creator><creator>Yee, Caitlin</creator><creator>Drost, Leah</creator><creator>Leung, Eric</creator><creator>Sousa, Philomena</creator><creator>Lewis, Donna</creator><creator>Lam, Henry</creator><creator>Chow, Ronald</creator><creator>Lock, Michael</creator><creator>Chow, Edward</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201910</creationdate><title>Symptom clusters in patients with breast cancer receiving radiation therapy</title><author>Chow, Selina ; Wan, Bo Angela ; Pidduck, William ; Zhang, Liying ; DeAngelis, Carlo ; Chan, Stephanie ; Yee, Caitlin ; Drost, Leah ; Leung, Eric ; Sousa, Philomena ; Lewis, Donna ; Lam, Henry ; Chow, Ronald ; Lock, Michael ; Chow, Edward</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-d42870ffe3cb7ee277cf44d07af1da99bda92b8cfeebdd33e3cef738baf8eac33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anxiety - diagnosis</topic><topic>Anxiety - epidemiology</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - psychology</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Cancer Pain - diagnosis</topic><topic>Cancer Pain - epidemiology</topic><topic>Cluster Analysis</topic><topic>Depression - diagnosis</topic><topic>Depression - epidemiology</topic><topic>Dyspnea - diagnosis</topic><topic>Dyspnea - epidemiology</topic><topic>Edmonton symptom assessment system</topic><topic>Factor Analysis, Statistical</topic><topic>Fatigue - diagnosis</topic><topic>Fatigue - epidemiology</topic><topic>Feeding and Eating Disorders - diagnosis</topic><topic>Feeding and Eating Disorders - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Nausea - diagnosis</topic><topic>Nausea - epidemiology</topic><topic>Nursing</topic><topic>Principal Component Analysis</topic><topic>Radiotherapy</topic><topic>Symptom Assessment - methods</topic><topic>Symptom clusters</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chow, Selina</creatorcontrib><creatorcontrib>Wan, Bo Angela</creatorcontrib><creatorcontrib>Pidduck, William</creatorcontrib><creatorcontrib>Zhang, Liying</creatorcontrib><creatorcontrib>DeAngelis, Carlo</creatorcontrib><creatorcontrib>Chan, Stephanie</creatorcontrib><creatorcontrib>Yee, Caitlin</creatorcontrib><creatorcontrib>Drost, Leah</creatorcontrib><creatorcontrib>Leung, Eric</creatorcontrib><creatorcontrib>Sousa, Philomena</creatorcontrib><creatorcontrib>Lewis, Donna</creatorcontrib><creatorcontrib>Lam, Henry</creatorcontrib><creatorcontrib>Chow, Ronald</creatorcontrib><creatorcontrib>Lock, Michael</creatorcontrib><creatorcontrib>Chow, Edward</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of oncology nursing : the official journal of European Oncology Nursing Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chow, Selina</au><au>Wan, Bo Angela</au><au>Pidduck, William</au><au>Zhang, Liying</au><au>DeAngelis, Carlo</au><au>Chan, Stephanie</au><au>Yee, Caitlin</au><au>Drost, Leah</au><au>Leung, Eric</au><au>Sousa, Philomena</au><au>Lewis, Donna</au><au>Lam, Henry</au><au>Chow, Ronald</au><au>Lock, Michael</au><au>Chow, Edward</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Symptom clusters in patients with breast cancer receiving radiation therapy</atitle><jtitle>European journal of oncology nursing : the official journal of European Oncology Nursing Society</jtitle><addtitle>Eur J Oncol Nurs</addtitle><date>2019-10</date><risdate>2019</risdate><volume>42</volume><spage>14</spage><epage>20</epage><pages>14-20</pages><issn>1462-3889</issn><eissn>1532-2122</eissn><abstract>Symptoms experienced by breast cancer patients often cluster together in groups known as “symptom clusters”. The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT).
Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points.
This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.
Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.
•Symptom clusters (SC) are symptoms experienced together, and are important in quality of life and symptom management.•This study evaluated SD in 1224 metastatic breast cancer patients before, during and after receiving radiotherapy (RT).•Two SC were found before the start of RT, with wellbeing, depression, and anxiety consistently clustered together.•End of RT found clustering of: wellbeing, depression, anxiety; nausea appetite; drowsiness dyspnea.•Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster.•Understanding the clustering of symptoms in this population can improve management of symptoms.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>31446259</pmid><doi>10.1016/j.ejon.2019.07.004</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1462-3889 |
| ispartof | European journal of oncology nursing : the official journal of European Oncology Nursing Society, 2019-10, Vol.42, p.14-20 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged Anxiety - diagnosis Anxiety - epidemiology Breast cancer Breast Neoplasms - complications Breast Neoplasms - psychology Breast Neoplasms - radiotherapy Cancer Pain - diagnosis Cancer Pain - epidemiology Cluster Analysis Depression - diagnosis Depression - epidemiology Dyspnea - diagnosis Dyspnea - epidemiology Edmonton symptom assessment system Factor Analysis, Statistical Fatigue - diagnosis Fatigue - epidemiology Feeding and Eating Disorders - diagnosis Feeding and Eating Disorders - epidemiology Female Humans Middle Aged Nausea - diagnosis Nausea - epidemiology Nursing Principal Component Analysis Radiotherapy Symptom Assessment - methods Symptom clusters |
| title | Symptom clusters in patients with breast cancer receiving radiation therapy |
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