Symptom Experiences and Symptom Cluster across Dimensions in Thais with Advanced Lung Cancer

Abstract: This study explores symptom experiences and symptom clusters in persons with advanced lung cancer receiving chemotherapy. Using convenience sampling, 300 Thai participants with advanced lung cancer undergoing chemotherapy were recruited from one university hospital and cancer hospital in Bangkok. Data were collected using two questionnaires: a demographic questionnaire, and the Memorial Symptom Assessment Scale. Descriptive statistics was used to determine symptom experience, and a Principal Component Factor with a Varimax rotation was used to analyze clustering of symptoms. The results showed that the participants experienced multiple symptoms simultaneously. Lack of appetite was rated as the most prevalent and severe symptom. A problem with urination was rated as the most frequent symptom and constipation was rated as the most distressing symptom. Five symptom clusters existed in both dimensions of symptom severity and distress. However, the symptoms that loaded in each cluster and the name of the clusters were slightly different. The clusters in severity were ‘Emotional-elimination discomfort’, ‘Anorexia-related’, ‘Treatment-related gastrointestinal and other’, ‘Neurological and body image’, and ‘Respiratory and sleep disturbance’. Clusters in symptom distress were ‘Emotional-elimination discomfort’, ‘Body image’, ‘Anorexia-related’, ‘Treatment-related gastrointestinal and other’, ‘Treatment-related neurological and other’. Future research needs a longitudinal design to identify symptom patterns that might change over time along the disease and treatment trajectory. Our findings could be used to develop an intervention program for managing cluster of symptoms, provided they have an underlying common cause.