Psychoneurological Symptom Clusters in Patients with Cancer: A Concept Analysis.

OBJECTIVES

To clarify the concept of psychoneurological (PN) symptom clusters in patients with cancer.

METHODS

Walker and Avant's concept analysis method was applied. A comprehensive search of PubMed, Embase, CINAHL, and PsycINFO using PN symptom cluster and other symptom- and cancer-related terms identified 51 records for synthesis. Data on defining attributes, antecedents, empirical referents, and consequences were extracted from each record and analyzed for recurrent themes.

RESULTS

The defining attributes of PN symptom clusters in cancer are the co-occurrence of two or more interrelated symptoms spanning at least two of three core domains-affective, somatic, and cognitive-reflecting a multidimensional PN symptom experience. Identified antecedents included biological, psychological, and contextual factors that shape the symptom experience. Consequences included reduced functional and global health-related quality of life. Empirical referents were primarily symptom scores derived from patient-reported outcome measures and used in cluster modeling.

CONCLUSIONS

This conceptualization of PN symptom clusters may promote more consistent use of the term across clinical and research settings.

IMPLICATIONS FOR NURSING PRACTICE: This analysis underscores the importance of routine screening for co-occurring symptoms across affective, somatic, and cognitive domains throughout cancer treatment and survivorship.