Symptom clusters among Chinese women with breast cancer

Abstract

Background: breast cancer patients were found to experience multiple concurrent symptoms. These concurrent symptoms (termed symptom cluster) could have synergistic effects on patient functional status and quality of life. Understanding symptom cluster provided us new insight in symptom assessment and symptom management. Previous studies on symptom cluster among breast cancer patients focused on Caucasian. The current study attempt to identify symptom cluster and the factors associated with it among Chinese breast cancer patients.

Methods: this study was a secondary analysis on a sample of 348 breast cancer patients. Data on symptom distress (assessed by Memorial symptom Assessment scale Short Form) was retrieved. Symptom clusters were identified through factor analysis using principal components method and Varimax rotation. Demographics and medical characteristics were proposed to be associated with symptom cluster. Uni-variate analysis and linear regression performed on these variables.

Results: four symptom clusters (namely gastrointestinal cluster, general malaise cluster, self image cluster, and cutaneous cluster) were identified. Recurrence of breast cancer and chemotherapy were associated with either gastrointestinal cluster or general malaise cluster. Age, cancer status and occupation were associated with self image cluster while no variable was associated with cutaneous cluster.

Conclusion: The current study provided empirical evidence that Chinese breast cancer patients experienced similar symptom clusters as Caucasian. Future study could be done to verify these four symptom clusters and identify underlying mechanism.

Recommendations: health care providers could pay more attention to those suffer from breast cancer recurrence or currently receiving chemotherapy. These patients tend to experience gastrointestinal cluster and general malaise cluster. Clinical setting and evaluation tools could be adjusted to fit these high risk groups.