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The Influence of Multiple Chronic Conditions on Symptom Clusters in People With Solid Tumor Cancers
Seyedehtanaz Saeidzadeh1, Yelena Perkhounkova, Stephanie Gilbertson-White
1Authors' affiliation: University of Iowa College of Nursing, Iowa City.
Background:
People with cancer who also have multiple chronic conditions (MCCs) experience co-occurring symptoms known as symptom clusters.
Objective:
To describe MCC and symptom clusters in people with cancer and to evaluate the relationships between MCCs and symptom severity, symptom interference with daily life, and quality of life (QoL).
Methods:
Weekly over a 3-week chemotherapy cycle, 182 adults with solid tumor cancer receiving chemotherapy completed measures of symptom severity, symptom interference with daily life, and QoL. Medical records reviewed to count number of MCCs in addition to cancer. Exploratory factor analysis was performed to identify symptom clusters. The relationships between the number of MCCs and the outcomes (symptom severity and symptom interference with daily life and QoL) at each time point were examined using the χ2 test. Longitudinal changes in outcomes were examined graphically.
Results:
The number of MCCs ranged from 0 to 9, but most participants (62.1%) had 2 or fewer MCCs. Obesity was the most prevalent chronic condition. Four symptom clusters were identified: nutrition, neurocognitive, abdominal discomfort, and respiratory clusters. At each time point, no significant differences were found for MCCs and any outcome. However, symptom severity in all the symptom clusters, symptom interference with daily life, and QoL demonstrated a worsening in the week following chemotherapy.
Conclusion:
A majority of our sample had 2 or fewer MCCs, and MCCs did contribute to patient outcomes. Rather, timing of chemotherapy cycle had the greatest influence of patient outcomes.
Implications For Practice:
Additional support on day 7 of chemotherapy treatment is needed for people with MCCs.
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