Symptom clusters in Thai patients with advanced lung cancer

Abstract

To explore the characteristics of symptoms and to explore the presence and composition of symptom clusters in Thai patients with advanced lung cancer, based on the Theory of Unpleasant Symptoms. One hundred and sixty five patients with advanced lung were purposively selected from out- and in-patient oncology clinics at two tertiary hospitals in Bangkok to complete a demographic questionnaire and the Memorial Symptom Assessment Scale (MSAS). The results found that patients with advanced lung cancer age range between 35 and 84 years, with a mean of 62.4 years accompanied by multiple symptoms, averaged 14.65 symptoms during their disease and treatment. Coughing was the reported symptom. Lack of appetite was the symptom reported to be the most frequently occurring. Pain was the symptom reported to be the most severe as well as the most distressful. Seven symptom clusters were identified by using Factor Analysis with 63.24% of variance explained. The factors were labeled as: body image symptom cluster, neuropsychological symptom cluster, sleep alteration symptom cluster, digestive impairment symptom cluster, dermatologic and dizziness symptom cluster, bowel-emotional dysfunction symptom cluster, and pain related discomfort symptoms cluster. Knowing which symptoms cluster together may trigger an investigation and intervention of other symptoms within the cluster. A more immediate strategy maybe targeting only one of the symptoms for intervention and closely following the effect on the associated symptoms in cluster. The results intimately suggest nursing intervention on symptom management for better quality of life in Thai patients with advanced lung cancer.