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Stability Of Symptom Clusters And Sentinel Symptoms During The Initial Phase Of Adjuvant Chemotherapy

出版	Morressier, 2017
URL	http://books.google.com.hk/books?id=NXF3zgEACAAJ&hl=&source=gbs_api

註釋IntroductionTop priorities in symptom cluster studies include confirming stable groups of symptoms and identifying sentinel symptoms. Understanding the stability of symptom clusters and identifying sentinel symptoms would facilitate effective symptom management. ObjectivesThis study aimed to evaluate the stability of symptom clusters and to identify sentinel symptoms during the initial phase of adjuvant chemotherapy (CTx).MethodsA descriptive correlational study design was applied. A total of 209 cancer patients receiving adjuvant CTx completed symptom evaluation for the 1st and 2nd cycles. The severity of 20 symptoms were evaluated on a 0 to 10 numeric rating scale. Statistical analysis include principal component and hierarchical cluster analyses to identify symptom clusters, and principal variable analysis to identify sentinel symptoms. ResultsFour symptom clusters were identified in the 1st cycle: a physical-psychological (pain, dyspnea, sleep disturbance, anxiety, depression), a gastrointestinal (nausea, loss of appetite, taste change), a fatigue-cognitive (fatigue, difficulty concentrating, drowsiness), and a urosexual (urinary problem, sexual problem) symptom cluster. In the 2nd cycle, stable symptom clusters were identified, whereas the physical-psychological and fatigue-cognitive symptom cluster were merged together resulting in 3 clusters. The identified sentinel symptoms were anxiety, loss of appetite and fatigue in the 1st cycle, and loss of appetite, depression, and fatigue in the 2nd cycle.ConclusionsSymptom clusters were stable during the initial phase of adjuvant CTx. Symptom management needs to focused on managing sentinel symptoms. Managing emotional symptoms and improving appetite with an evidence-based approach is necessary. It is also important to inform and prepare patients about fatigue management.