Influencing Factors of Symptom Clusters in Cancer Patients

Tuesday, 14 July 2009

Hee-Ju Kim, PhD
Department of Nursing, University of Ulsan, Ulsan, South Korea

Learning Objective 1: describe the importance of symptom clusters in caring cancer patients for symptom assessment and management.

Learning Objective 2: describe the influencing factors of symptom clusters and implications of those factors in research as well as practice.

Purpose: The symptom clusters is an oncology priority research area. Targeting a multiple symptoms for assessment and management will be more beneficial than individual symptoms. This paper examined the possible influencing factors of symptom clusters in cancer patients through review of literature on symptom prevalence/severity.

Methods: Data were retrieved from the databases (Medline and CINHAL, 1995-2005) with combinations of key words: cancer, breast cancer, symptoms, fatigue, depression/psychological distress, sleep/insomnia, correlates, predictors, and associated factors. For additional literature, the snowball literature sampling was used.

Results: This work identified the potential influencing factors of symptom clusters: (a) demographic characteristics (age, gender, employment status, marital status); (b) disease-related characteristics (stage of cancer, cancer site, comorbid condition); (c) treatment-related characteristics (treatment type, treatment trajectory, time lapse since treatment); and (d) situational factors (functional status, psychological distress).


This study indicates that a certain symptom cluster may occur at a specific time period and/or to patients with a specific characteristic. The literature review also indicates the lack of study on influencing factors on symptom clusters. Examining the influencing factors may reveal conditions in which we can observe a certain symptom cluster, and can even suggest a clue why symptoms are clustering. Future research need to examine whether the potential influencing factors have actual impact.