College of Nursing, University of Illinois, Chicago; Christian Medical College, Vellore, India.
Christian Medical College, Vellore, India.
Semin Oncol Nurs. 2021 Oct;37(5):151215. doi: 10.1016/j.soncn.2021.151215. Epub 2021 Sep 3.
The two approaches to symptom-cluster research include grouping symptoms and grouping patients. The objective of this systematic review was to examine the conceptual approaches and methodologies used in symptom-cluster research in patients with head and neck cancer.
Articles were retrieved from electronic databases (CINAHL, MEDLINE via Ovid, APA PsycINFO, Scopus, Embase, and Cochrane Central Register of Controlled Trials-CENTRAL), five grey literature portals, and Google Scholar. Seventeen studies met the eligibility criteria. Eight studies grouped symptoms to identify symptom clusters, of which two used qualitative methods. The number of symptom clusters ranged from two to five, and the number of symptoms in a cluster ranged from 2 to 11. Nine studies grouped patients based on their experiences with multiple symptoms. Cluster analysis and factor analysis were most commonly used. Despite variable names and composition of symptom clusters, synthesis revealed three prominent symptom clusters: general, head and neck cancer-specific, and gastrointestinal. Being female and quality of life were significantly associated with high symptom group or cluster severity. Biological mechanisms were sparsely examined.
Symptom cluster research in head and neck cancer is emerging. Consensus on nomenclature of a symptom cluster will facilitate deduction of core clinically relevant symptom clusters in head and neck cancer. Further research is required on understanding patients' subjective experiences, identifying predictors and outcomes, and underlying mechanisms for symptom clusters.
Identification of clinically relevant symptom clusters would enable targeted symptom assessment and management strategies, thus improving treatment efficiencies and patient outcomes.
症状群研究有两种方法，即按症状分组和按患者分组。本系统综述的目的是检查头颈部癌症患者的症状群研究中使用的概念方法和方法学。
文章从电子数据库（CINAHL、通过 Ovid 检索的 MEDLINE、APA PsycINFO、Scopus、Embase 和 Cochrane 对照试验中心注册库-CENTRAL）、五个灰色文献门户和 Google Scholar 中检索到文章。有 17 项研究符合入选标准。有 8 项研究按症状分组以确定症状群，其中 2 项使用了定性方法。症状群的数量从 2 到 5 不等，一个群中症状的数量从 2 到 11 不等。有 9 项研究根据患者的多种症状经历对患者进行分组。聚类分析和因子分析最常用。尽管症状群的名称和组成不同，但综合分析显示出三个主要的症状群：一般症状群、头颈部癌症特异性症状群和胃肠道症状群。女性和生活质量与高症状组或症状群严重程度显著相关。生物机制研究较少。
头颈部癌症的症状群研究正在兴起。症状群命名的共识将有助于推导出头颈部癌症中核心的、临床相关的症状群。需要进一步研究以了解患者的主观体验、识别预测因素和结果以及症状群的潜在机制。
识别出临床上相关的症状群，将能够进行有针对性的症状评估和管理策略，从而提高治疗效率和患者结局。
