Symptom Clusters Predictive of Quality of Life Among Jordanian Women with Breast Cancer

doi:10.1016/j.soncn.2021.151144

Seminars in Oncology Nursing

Volume 37, Issue 2, April 2021, 151144

https://doi.org/10.1016/j.soncn.2021.151144 Get rights and content

Abstract

Objectives

This study was conducted to explore symptom clusters among women with breast cancer in Jordan.

Data Sources

A cross-sectional survey of 516 women with breast cancer who were recruited from three hospitals.

Conclusion

This study demonstrated that women with breast cancer experienced several symptoms at the same time. These symptoms tend to cluster in five main groups, and patients experiencing the psychological, nausea and vomiting, and pain clusters are expected to have a lower mean score of quality of life.

Implications for Nursing Practice

Nurses need to assess and manage symptoms as clusters to improve the quality of life of women with breast cancer. Symptoms clusters should guide symptoms management practice and be given a priority equal to the active treatment of cancer. Symptoms management and cancer treatment should be started simultaneously.

Section snippets

Background

Women with breast cancer usually have more than one symptom at a time, known as a “cluster” of symptoms.¹^,² A symptom cluster consists of two or more interrelated symptoms that occur concurrently, caused by one or more etiologies. Symptom clusters are composed of stable groups of symptoms, are relatively independent of other clusters, and may reveal specific underlying dimensions of symptoms.³ Breast cancer treatments include a combination of surgery, radiotherapy, chemotherapy, hormonal

Design

A cross-sectional survey design was used.

Settings

This study was conducted in three hospitals in Jordan, where most patients with cancer are usually treated. The hospitals are: (i) a specialized cancer centre located in Amman (capital of Jordan), (ii) a university-affiliated hospital located in the northern part of the country, and (iii) a government referral hospital in Amman.

Sample and sample size

The sample consisted of 516 women with breast cancer who were recruited through convenience sampling. Eligible participants were

Sample characteristics

Of the 556 women with breast cancer who were approached, 23 refused to participate, 8 left the questionnaires incomplete, and 9 quit due to tiredness. So, 516 questionnaires were eligible for analysis. The mean age of the participants was 51.8 (standard deviation [SD] 15.8) years. A total of 368 participants (71.3%) were married; 56.2% were undergoing treatment, with a large proportion (29.7%) treated by chemotherapy. The full description of the participants’ characteristics is presented in

Discussion

The results of this study demonstrated that women with breast cancer experienced multiple symptoms concurrently and that most of these symptoms were perceived to be distressing. The most reported symptoms were fatigue, lower back pain, and worrying. Reported symptoms were grouped into five main clusters: psychological, treatment side effects, pain, nausea and vomiting, and fatigue. The psychological, nausea and vomiting, and pain clusters were found to be strongly associated with the quality of

Conclusion

This study demonstrated that women with breast cancer experienced several symptoms at the same time. These symptoms tend to be clustered in five main groups, some predicting especially poor quality of life. It is recommended investigating the possibility of having core symptoms in each cluster that trigger the occurrence of others; theoretically, therefore, treating the core symptoms may make other symptoms subside or even prevent their occurrence. If this hypothesis is proven to be correct, it

Declaration of Competing Interest

Authors have no conflict of interest to declare.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Symptom Clusters Predictive of Quality of Life Among Jordanian Women with Breast Cancer

Abstract

Objectives

Data Sources

Conclusion

Implications for Nursing Practice

Section snippets

Background

Design

Settings

Sample and sample size

Sample characteristics

Discussion

Conclusion

Declaration of Competing Interest

Funding

Semin Oncol Nurs

Semin Oncol Nurs

Eur J Oncol Nurs

J Pain Symptom Manage

J Pain Symptom Manage

Eur J Cancer

Clin Breast Cancer

J Pain Symptom Manage

J Pain Symptom Manage

Eur J Oncol Nurs

J Pain Symptom Manage