Medical and psychosocial symptom clusters and their temporal patterns in people with cancer.

PURPOSE: Symptom clusters (SC) negatively impact functioning and quality of life (QOL). Existing SC research is largely cross-sectional, focused on advanced and/or single cancer types, and does not encompass physical, functional, and psychosocial symptoms. This secondary analysis examined SCs in newly diagnosed, actively treated patients across diverse cancers, assessed SC temporal stability, and identified core symptoms.

METHODS

Archival data from three RCTs of the Finding My Way intervention were analysed [1-3]. Physical, functional, and QOL symptoms were measured using the EORTC QLQ-C30 [4], and psychological symptoms were assessed via the DASS-21 [5]. SCs were identified through EFA at baseline (N = 300) and 3 months post-intervention in both control (n = 151) and intervention (n = 149) groups.

RESULTS

Physical (α = .85), psychological (α = .90), and gastrointestinal (α = .63) clusters were identified at baseline. Core symptoms were role functioning (.92), stress (- .92), and nausea and vomiting (.66), respectively. Only the psychological cluster was temporally stable. The gastrointestinal cluster appeared only at baseline, while the physical cluster was persistent but temporally unstable. Cluster presence was varied at baseline (physical = 83%, psychological = 42%, gastrointestinal = 29%) and at 3 months (control: psychological = 48%, physical = 46%, simultaneously = 42%; intervention: psychological = 41%, physical = 46%, simultaneously = 33%).

CONCLUSION

Psychological, physical, and gastrointestinal clusters were identified, with only psychological demonstrating temporal stability. Stress and role functioning emerged as core symptoms. Future research should prioritise multicomponent interventions targeting psychological and physical SCs and core symptoms.