The influence of symptom clusters and the most distressing concerns regarding quality of life among patients with inoperable lung cancer
- Ingela Henocha, b,
, 
, - Malin Lövgrenc
Abstract
Purpose
To
explore the influence of symptom clusters and the most distressing
concerns on global rating of quality of life (QoL) among patients with
inoperable lung cancer (LC) over a three-month period following
diagnosis.
Methods
Data
were derived from a longitudinal study dealing with the symptom
experiences of 400 patients with LC at three time points: close to
diagnosis and one and three months later. The symptom clusters were
derived from a QoL questionnaire using factor analysis, which resulted
in three clusters: the Respiratory cluster, the Pain cluster and the
Mood cluster. The most distressing concerns were derived from responses
to a free listing question (‘What is most distressing at present’) and
were categorised under three dimensions: Bodily distress, Life situation
with LC and Iatrogenic distress. Cross-sectional, multivariate
regression analyses with QoL as a dependent variable were used to
determine predictors (symptom clusters and most distressing concerns) at
the three time points.
Results
All
three symptom clusters predicted QoL at each time point. Close to
diagnosis, none of the dimensions of most distressing concerns predicted
QoL, while the dimension Bodily distress was a significant predictor of
QoL after one month. The Life situation with LC dimension was a
significant predictor of QoL three months after diagnosis.
Conclusions
Symptom
clusters are important to LC patients' QoL and need to be acknowledged
by healthcare professionals. The present study shows the importance of
patients' descriptions of key concerns, which vary from diagnosis
onwards, and urges healthcare professionals to be vigilant to such
changes.
Keywords
- Symptom experience;
- Symptom cluster;
- Distress;
- Free listing;
- Lung cancer;
- Quality of life
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