Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;26(8):2685-2693.
doi: 10.1007/s00520-018-4102-8. Epub 2018 Feb 23.

Relationship among symptom clusters, quality of life, and treatment-specific optimism in patients with cancer

Martin Matzka  1 , Sabine Köck-Hódi  2 , Patrick Jahn  3 , Hanna Mayer  2
Affiliations

Relationship among symptom clusters, quality of life, and treatment-specific optimism in patients with cancer

Martin Matzka et al. Support Care Cancer. 2018 Aug.

Abstract

Purpose: There is increasing evidence that disease and therapy-related symptoms frequently co-occur in so-called symptom clusters (SCs), which may significantly impair quality of life in patients with cancer. Although psychosocial resources may play pivotal roles in maintaining or improving quality of life, they have been neglected in SC research. Therefore, we aim to identify SCs and their relative impact on quality of life when psychosocial resources are accounted for.

Methods: Patients with cancer (n = 304) undergoing chemotherapy or chemo-radiation therapy participated in a cross-sectional survey consisting of measures assessing symptoms, quality of life, resilience, treatment-specific optimism (TSO), and social support. Exploratory factor analyses and multiple regression analyses were used to identify SCs and significant explanatory variables of overall quality of life.

Results: Fatigue-pain, anxiety-depression, cancer therapy-related toxicity, and nausea-vomiting clusters were identified. In our final model, the fatigue-pain cluster (β = - 0.41, p < 0.001), nausea-vomiting cluster (β = - 0.28, p < 0.001), TSO (β = 0.21, p < 0.001), and receiving chemo-radiation treatment (β = - 0.11, p = 0.03) accounted for 44% of variance in overall quality of life. However, the identified SCs explained quality of life in patients with varying levels of TSO to a different extent.

Conclusions: Our findings indicate that the TSO of patients may be a major factor to consider in managing SCs, because-depending on its level-different SCs and even clusters encompassing comparatively less distressing symptoms (i.e., cancer therapy-related toxicities) may strongly affect quality of life.

Keywords: Cancer therapy toxicity; Health-related quality of life; Resilience; Symptom; Symptom cluster; Treatment-specific optimism.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Significant explanatory variables of overall quality of life
Fig. 2
Fig. 2
Significant explanatory variables of overall quality of life in patients with low, medium, and high treatment-specific optimism (TSO), from top to bottom
See this image and copyright information in PMC

References

    1. Fan G, Filipczak L, Chow E. Symptom clusters in cancer patients: a review of the literature. Curr Oncol. 2007;14(5):173–179. doi: 10.3747/co.2007.145. - DOI - PMC - PubMed
    1. Miaskowski C, Dodd M, Lee K. Symptom clusters: the new frontier in symptom management research. J Natl Cancer Inst Monogr. 2004;2004(32):17–21. doi: 10.1093/jncimonographs/lgh023. - DOI - PubMed
    1. Kroenke K, Johns SA, Theobald D, Wu J, Tu W. Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability. Support Care Cancer. 2013;21(3):765–773. doi: 10.1007/s00520-012-1578-5. - DOI - PMC - PubMed
    1. Walsh D, Rybicki L. Symptom clustering in advanced cancer. Support Care Cancer. 2006;14(8):831–836. doi: 10.1007/s00520-005-0899-z. - DOI - PubMed
    1. Kirkova J, Aktas A, Walsh D, Davis MP. Cancer symptom clusters: clinical and research methodology. J Palliat Med. 2011;14(10):1149–1166. doi: 10.1089/jpm.2010.0507. - DOI - PubMed

LinkOut - more resources