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http://dx.doi.org/10.4040/jkan.2009.39.5.683

Identification and Validation of Symptom Clusters in Patients with Hepatocellular Carcinoma  

Cho, Myung-Sook (Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kwon, In-Gak (Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Hee-Sun (Department of Nursing, Samsung Medical Center)
Kim, Kyung-Hee (Department of Nursing, Chung-Ang University)
Ryu, Eun-Jung (Department of Nursing, Konkuk University)
Publication Information
Journal of Korean Academy of Nursing / v.39, no.5, 2009 , pp. 683-692 More about this Journal
Abstract
Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.
Keywords
Symptom; Cluster; Hepatocellular carcinoma;
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