Liang Fu1, Xiuqin Feng2, Yongyan Jin2, Zhenqi Lu3, Rufang Li4, Wenxia Xu5, Victor T Chang6, Yan Hu7, Xianghong Ye8. 1. Department of Nursing (L.F., R.L., X.Y.), Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang; Central Laboratory (L.F., W.X.), Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang; School of Nursing (L.F., Y.H.), Fudan University, Shanghai. 2. Department of Nursing (X.F., Y.J.), the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang. 3. Department of Nursing (Z.L.), Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. 4. Department of Nursing (L.F., R.L., X.Y.), Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang. 5. Central Laboratory (L.F., W.X.), Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang. 6. Department of Medicine (V.T.C.), Rutgers-New Jersey Medical School, and Section of Hematology Oncology, Veterans Affairs New Jersey Health Care System, Newark, New Jersey, USA. 7. School of Nursing (L.F., Y.H.), Fudan University, Shanghai. Electronic address: huyan@fudan.edu.cn. 8. Department of Nursing (L.F., R.L., X.Y.), Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang. Electronic address: 13868992616@163.com.
Abstract
CONTEXT: Although gastric cancer is one of the most common tumors worldwide, there is little knowledge about symptom clusters and quality of life (QoL) in this population. OBJECTIVES: The objectives were to identify the symptom clusters in gastric cancer patients receiving chemotherapy, and explore their effects on QoL. METHODS: Gastric cancer patients receiving chemotherapy were recruited. Data were collected using the Memorial Symptom Assessment Scale Short Form, the Functional Assessment of Cancer Therapy-Gastric and the self-designed General Information Evaluation Form. The symptom clusters were extracted through the exploratory factor analysis. The influencing factors of symptom clusters and their effects on QoL were identified using multiple linear regression analysis. RESULTS: A total of 322 participants were enrolled from three medical centers. Five factors were identified in this exploratory factor analysis based on symptom prevalence, namely fatigue related symptom cluster, epithelial symptom cluster, neurologic symptom cluster, malnutrition related symptom cluster and psychological symptom cluster (χ2 = 31.470, P < 0.05). The affecting factors across symptom clusters and QoL subscales were relatively stable, but also different. Generally, fatigue related symptom cluster, malnutrition related symptom cluster and psychological symptom cluster demonstrated significantly negative effects on all aspects of QoL except social well being. CONCLUSION: Five symptom clusters were identified in gastric cancer patients receiving chemotherapy in mainland China. The symptom clusters negatively contributed to the variance in all aspects of QoL except social well being. Further studies should examine interventions for symptom clusters, their influencing factors, and their effects on improving QoL.
CONTEXT: Although gastric cancer is one of the most common tumors worldwide, there is little knowledge about symptom clusters and quality of life (QoL) in this population. OBJECTIVES: The objectives were to identify the symptom clusters in gastric cancer patients receiving chemotherapy, and explore their effects on QoL. METHODS: Gastric cancer patients receiving chemotherapy were recruited. Data were collected using the Memorial Symptom Assessment Scale Short Form, the Functional Assessment of Cancer Therapy-Gastric and the self-designed General Information Evaluation Form. The symptom clusters were extracted through the exploratory factor analysis. The influencing factors of symptom clusters and their effects on QoL were identified using multiple linear regression analysis. RESULTS: A total of 322 participants were enrolled from three medical centers. Five factors were identified in this exploratory factor analysis based on symptom prevalence, namely fatigue related symptom cluster, epithelial symptom cluster, neurologic symptom cluster, malnutrition related symptom cluster and psychological symptom cluster (χ2 = 31.470, P < 0.05). The affecting factors across symptom clusters and QoL subscales were relatively stable, but also different. Generally, fatigue related symptom cluster, malnutrition related symptom cluster and psychological symptom cluster demonstrated significantly negative effects on all aspects of QoL except social well being. CONCLUSION: Five symptom clusters were identified in gastric cancer patients receiving chemotherapy in mainland China. The symptom clusters negatively contributed to the variance in all aspects of QoL except social well being. Further studies should examine interventions for symptom clusters, their influencing factors, and their effects on improving QoL.