Symptom clusters and quality of life in survivors of lung cancer

Sherry W Fox, Debra E Lyon
Oncology Nursing Forum 2006, 33 (5): 931-6

PURPOSE/OBJECTIVES: To explore the prevalence and intensity of depression, fatigue, and pain in survivors of lung cancer; to examine the relationship of symptoms in a cluster; and to examine the relationship of the symptom cluster to quality of life (QOL).

DESIGN: Secondary data analysis.

SETTING: Online lung cancer support group.

SAMPLE: 51 patients diagnosed with lung cancer.

METHODS: Mailed survey with self-report of depression, fatigue, and pain measured by subscales of the Short-Form 36 Health Status Survey and QOL measured by the Fox Simple QOL Scale. Pearson's correlation and multiple regression analyses were used to examine the possible symptom cluster.

MAIN RESEARCH VARIABLES: Depression, fatigue, pain, and QOL.

FINDINGS: Depression, fatigue, and pain were found in a majority of survivors, with pain being the least common symptom. Fatigue was the most intense of the three symptoms. Two significantly correlated symptoms were depression and fatigue. The cluster explained 29% (p less than 0.01) of the variance in QOL in the lung cancer survivors.

CONCLUSIONS: The data provided preliminary support for the presence of a symptom cluster in patients with lung cancer consisting of depression and fatigue. The cluster had a negative relationship with QOL. Survivors of lung cancer have depression and fatigue that affect QOL.

IMPLICATIONS FOR NURSING: Healthcare providers must assess the potential for symptoms to cluster, adversely affecting key patient outcomes such as QOL. Through increased knowledge of symptom clusters, clinicians will be able to more effectively target the most distressing set of symptoms for intervention.

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