Department of Physiological Nursing and Office of Research, School of Nursing, University of California-San Francisco, 2 Koret Way, San Francisco, CA 94143-0610, USA.
Cancer Nurs. 2012 Jan-Feb;35(1):19-28. doi: 10.1097/NCC.0b013e31822909fd.
Symptom cluster research is an emerging field in symptom management. The ability to identify symptom clusters that are specific to pediatric oncology patients may lead to improved understanding of symptoms' underlying mechanisms among patients of all ages.
The purpose of this study, in a sample of children and adolescents with cancer who underwent a cycle of myelosuppressive chemotherapy, was to compare the number and types of symptom clusters identified using patients' ratings of symptom occurrence and symptom severity.
Children and adolescents with cancer (10-18 years of age; N = 131) completed the Memorial Symptom Assessment Scale 10-18 on the day they started a cycle of myelosuppressive chemotherapy, using a 1-week recall of experiences. Symptom data based on occurrence and severity ratings were examined using exploratory factor analysis. The defined measurement model suggested by the best exploratory factor analysis model was then examined with a latent variable analysis.
Three clusters were identified when symptom occurrence ratings were evaluated, which were classified as a chemotherapy sequela cluster, mood disturbance cluster, and a neuropsychological discomfort cluster. Analysis of symptom severity ratings yielded similar cluster configurations.
Cluster configurations remained relatively stable between symptom occurrence and severity ratings. The evaluation of patients at a common point in the chemotherapy cycle may have contributed to these findings.
Additional uniformity in symptom clusters investigations is needed to allow appropriate comparisons among studies. The dissemination of symptom cluster research methodology through publication and presentation may promote uniformity in this field.
症状群研究是症状管理领域的一个新兴领域。能够识别出特定于儿科肿瘤患者的症状群，可能会提高对所有年龄段患者症状潜在机制的理解。
本研究在接受骨髓抑制性化疗周期的儿童和青少年癌症患者样本中，旨在比较使用患者对症状发生和严重程度的评分来识别症状群的数量和类型。
癌症儿童和青少年（10-18 岁；N=131）在开始骨髓抑制性化疗周期的当天，使用 1 周的回忆经历完成了 10-18 岁纪念症状评估量表。使用探索性因素分析检查基于发生和严重程度评分的症状数据。然后使用潜在变量分析检查最佳探索性因素分析模型建议的定义测量模型。
评估症状发生评分时确定了三个群集，分别归类为化疗后遗症群集、情绪障碍群集和神经心理不适群集。对症状严重程度评分的分析得出了类似的群集配置。
在症状发生和严重程度评分之间，群集配置保持相对稳定。在化疗周期的共同时间点对患者进行评估可能促成了这些发现。
需要在症状群研究中增加更多的一致性，以便能够在研究之间进行适当的比较。通过出版和展示传播症状群研究方法学，可能会促进该领域的一致性。
