Longitudinal study on the changes of symptom clusters among nasopharyngeal carcinoma patients undergoing radiation therapy

Abstract

Objective To investigate the dynamic changes of symptom clusters among nasopharyngeal carcinoma patients receiving radiotherapy and provide evidence for intervention clinically. Methods The data were collected at three time points that were before radiotherapy, during the radiotherapy and after radiotherapy, by surveying 273 first visit of nasopharyngeal carcinoma patients from May 2014 to January 2015 with a self-designed general information questionnaire and the Chinese version of the M. D. Anderson symptom inventory and observing the changes of symptom clusters in our hospital. One-way analysis of variance and the exploratory factor analysis were applied to observe the incidence of symptoms and the changes of symptom clusters during radiotherapy. Results The statistics revealed that the incidence and intensity of all the symptoms at 3 time points were significantly increased(P<0.05), except the symptom of amnesia. There were 3 symptom clusters among 3 time points, named as gastrointestinal symptom cluster, sickness symptom cluster and somatic symptom cluster, but the composition and the variance were different at different time point. Gastrointestinal symptom cluster was made of nausea and vomiting, adding poor appetite only before radiotherapy. The gastrointestinal symptom cluster was most prominent before radiotherapy. Sickness symptom cluster consisted of drowsiness, numbness symptom before radiotherapy, while it consisted of shortness of breath, numbness, difficulty remembering symptoms in other time. Somatic symptom cluster mainly consisted of pain and fatigue, dry mouth symptom joining it during and after radiotherapy. Conclusions With the treatment of radiotherapy, the incidence and intensity of symptoms are significantly enhanced, and the constitution of symptom clusters is different at different stage. Therefore, it is important for clinical nurses to strengthen dynamic assessment of all symptoms, monitor the changes and composition of symptom clusters, thus establish corresponding management measures to improve patients′ quality of life. Key words: Longitudinal study; Nasopharyngeal carcinoma; Radiotherapy; Symptom cluster