Congress Abstracts 2006

240

SYMPTOM CLUSTER GROUPINGS' MEMBERSHIP CHANGES OVER ONE YEAR. Marylin Dodd, RN, PhD, FAAN, Maria Cho, RN, PhD, Bruce Cooper, PhD, Christine Miaskowski, RN, PhD, FAAN, Kathryn A. Lee, RN, PhD, and Kayee A. Bank, RN, MS, School of Nursing, University of California, San Francisco, San Francisco, CA.

Symptom clusters is a new frontier in symptom management research. There are an increasing number of published articles, but NO studies that have reported the changes in symptom cluster patient group membership over time. The present study will fill this void.

Research Questions:

1. Can groups of oncology outpatients be identified based on how their symptoms cluster (i.e., pain, fatigue, sleep disturbances, and depressive mood)?

2. Do patients in different symptom cluster groupings differ in outcomes (i.e., functional status and quality of life)?

3. Do symptom cluster group memberships change overtime during and after cancer treatment?

Symptom Management Model (Dodd, et al. 2001).

92 women with breast cancer, mean age of 50 years, completed several established instruments (i.e., Brief Pain Inventory, Piper's Fatigue Scale, General Sleep Disturbance Scale, CES-Depression, Karnofsky's Performance Status, and MQOL-CA2) three times in an ongoing randomized clinical trial. T1= baseline after the first cycle of CTX, T2= after completion of cancer treatment, T3= end of the study, 6 months after T2. Cluster analysis is a statistical technique used to cluster similar patients in subgroups based on their symptom experience.

Four symptom cluster groups were identified at T1, T2 & T3. The groupings were: Low on all symptom scores; High on all symptom scores; and two remaining cluster subgroups were a mix of high/moderate and low symptom scores with the severity of pain being the distinguishing feature between these two groupings.

The all Low symptom subgroup had significantly higher performance status and quality of life scores than the other 3 subgroups. Changes in cluster group membership clearly showed a shift from lower symptom severity to higher levels from T1 to T2; and a shift from higher levels to lower levels of severity during the recovery period from T2 to T3.

This presentation is the first to report changes in symptom clusters overtime and furthers our understanding of the course of the symptom experience, with implications for the impact of symptom clusters and the timing of interventions.