Learning Objective #1: understand symptom distress and symptom interference in patients with hepatoma

Learning Objective #2: realize the phenomena of symptom clusters in patients with hepatoma

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Cancer is the first leading cause of death in Taiwan. Hepatoma is ranked as the first cause of cancer mortality among males as the second cause among females in Taiwan. The purpose of this study was to describe symptom distress and symptom interference in patients with hepatoma and to explore the phenomena of symptom clusters. This study used demographic form and M. D. Anderson Symptom Inventory-Taiwan Form. 100 subjects were recruited by convenience sampling at two teaching hospitals in Taipei. Data were analyzed using descriptive statistics, pearson's correlation, regression analysis, factor analysis, and cluster analysis. The results showed that fatigue was highest symptom distress and symptom interference work was highest in the last 24 hours. Symptoms have correlated with each other in terms of its intensity, but pain and remembering have not correlated. The numbers of symptom were related to symptom distress intensity. The symptom numbers were 7.78 in overall patients with hepatoma. Results from cluster analysis reveal two clusters. Cluster one presents eight symptoms, distress, sad, fatigue, lack of appetite, drowsy, disturbed sleep, dry mouth, and pain. Cluster two presents five symptoms, nausea, vomiting, numbness or tingling, shortness of breath, and remembering. The result is the same with factor analysis. There are three factors including factor one presents Pain related symptoms, factor two presents GI related symptoms, and factor three presents Sensation related symptoms. Cluster one is in concordance with factor one. Also, cluster two is the same with factor two and three.

Hepatoma patients have experienced multiple symptom clusters. Results from this study can provide further research to manage multiple symptoms, most commonly simultaneously happened, in order to decrease symptom clusters and improve the quality of life for cancer patients.