| Learning Objective #1: Discuss the characteristics of women with breast cancer who experience similar and differing symptom profiles | |||
| Learning Objective #2: Identify patients at risk for changes in specific dimensions of their QOL related to occurrence of symptom clusters that vary in combination and severity |
Purpose:To compare patients with differing symptom clusters and overall QOL and its five subscales at three time points.
Methods:80 women with breast cancer, mean age 49 (SD=9.6), were part of an ongoing randomized clinical trial; completed QOL and symptom-specific questionnaires (sleep, fatigue, pain, and depression) at three time points; T1=during cancer treatment, T2=completion of cancer treatment, and T3=end of study. The questionnaires used have established reliability and validity. Cluster analysis identified patient groups, and Kruskal-Wallis test with post hoc pairwise Man-Whitney U-tests compared groups.
Results: A cluster analysis on symptom similarities yielded four relatively distinct patient groups: No Symptoms (NS); Pain & Fatigue (PF), moderate severity; Depression, Fatigue & Sleep (DFS) and Pain, Fatigue & Sleep (PFS) symptom clusters, moderate severity; and All Symptoms (AS), high severity. At each time point, significant differences among the symptom cluster groups in overall QOL were found. At T1, comparison between the NS and DFS groups yielded significant difference on overall QOL. At T2, significant differences were found for all subscales, except symptom distress, when comparing NS to AS. At T3, significant differences were found for overall QOL as well as the psychological and physical subscales when comparing NS to DFS, PFS, and AS.
Implications for Nursing: Patients with differing symptom profiles were identified that may predict current and future patients' morbidity; a new and promising area in symptom management.