Symptom clusters in adults with chronic health problems and cancer as a comorbidity

Catherine M Bender, Sandra J Engberg, Heidi S Donovan, Susan M Cohen, Martin P Houze, Margaret Q Rosenzweig, Gail A Mallory, Jacqueline Dunbar-Jacob, Susan M Sereika
Oncology Nursing Forum 2008, 35 (1): E1-E11

PURPOSE/OBJECTIVES: To identify and compare symptom clusters in individuals with chronic health problems with cancer as a comorbidity versus individuals with chronic health problems who do not have cancer as a comorbidity and to explore the effect of symptoms on their quality of life.

DESIGN: Secondary analysis of data from two studies. Study 1 was an investigation of the efficacy of an intervention to improve medication adherence in patients with rheumatoid arthritis (RA). Study 2 was an investigation of the efficacy of an intervention for urinary incontinence (UI) in older adults.

SETTING: School of Nursing at the University of Pittsburgh.

SAMPLE: The sample for study 1 was comprised of 639 adults with RA. The sample for study 2 was comprised of 407 adults with UI. A total of 154 (15%) subjects had a history of cancer, 56 (9%) of the subjects with RA and 98 (25%) of the subjects with UI.

METHODS: Analysis of existing comorbidity and symptom data collected from both studies.

MAIN RESEARCH VARIABLES: Symptom clusters, chronic disease, and cancer as a comorbidity.

FINDINGS: Individuals with chronic health problems who have cancer may not have unique symptom clusters compared to individuals with chronic health problems who do not have cancer.

CONCLUSIONS: The symptom clusters experienced by the study participants may be more related to their primary chronic health problems and comorbidities.

IMPLICATIONS FOR NURSING: Additional studies are needed to examine symptom clusters in cancer survivors. As individuals are living longer with the disease, a comprehensive understanding of the symptom clusters that may be unique to cancer survivors with comorbidities is critical.

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