Symptom burden survey and symptom clusters in patients with cervical cancer: a cross-sectional survey

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer(2023)

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Abstract
Purpose The purpose of this study is to determine the incidence and severity of symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy, form a symptom burden report, evaluate the distribution characteristics of symptoms, identify symptom clusters, and provide a basis for clinical doctors and nurses to improve the symptom management of patients with cervical cancer after radiotherapy and chemotherapy. Methods The patients with cervical cancer within 6 months after radiotherapy and chemotherapy were recruited to investigate their symptom burden. Exploratory factor analysis was used to identify symptom clusters. Results A total of 250 patients participated in the study. The study found that the most common symptom among the 40 symptoms was fatigue, and the most serious symptom was nocturia. Based on the occurrence rate and severity of symptoms, nine symptom clusters were identified, including psycho–emotion-related symptom cluster, pain–disturbed sleep-related symptom cluster, menopausal symptom cluster, tinnitus–dizziness-related symptom cluster, urinary-related symptom cluster, dry mouth–bitter taste-related symptom cluster, intestinal-related symptom cluster, memory loss–numbness-related symptom cluster, and emaciation-related symptom cluster. The three most serious symptom clusters are pain–disturbed sleep-related symptom cluster, urinary-related symptom cluster, and memory loss–numbness-related symptom cluster. Conclusion The symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy are complex, and nine symptom clusters can be identified according to the incidence and severity of symptoms. We can find the potential biological mechanism of each symptom cluster through the discussion of previous mechanism research and clinical research. The number of symptom clusters and the number of symptoms within the symptom cluster are closely related to the symptom evaluation scale selected for the study. Therefore, the symptom cluster study urgently needs a targeted symptom evaluation scale that can comprehensively reflect the patient’s condition.
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Key words
Symptom burden,Symptom clusters,Cervical cancer,Radiotherapy,Chemotherapy,Exploratory factor analysis
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