title: Symptom interactions as mechanisms underlying symptom pairs and clusters.
abstract: OBJECTIVE
  To present a summary of the potential shared or interactive mechanisms underlying an exemplar symptom pair: sleep disturbances and pain.
  
  
  METHODS
  Understanding of the multidimensional shared and interactive mechanisms underlying symptoms pairs and clusters has the potential to enhance symptom management.
  
  
  METHODS
  Reviews of the literature were conducted to search for information on shared or interactive mechanisms underlying sleep disturbances and pain; minimal data were available. Relevant information about individual symptoms was outlined and categorized in areas often used to describe the multidimensional nature of symptoms, including the physiological, psychological, behavioral, and sociocultural domains. This information was examined for relationships and commonalities.
  
  
  CONCLUSIONS
  Many potential shared and interactive mechanisms underlying the symptom pair of sleep disturbances and pain were identified. These results indicate the need for further work and theory development in this area. The symptom interactional framework is a beginning conceptual perspective designed to facilitate this work. Implications for interdisciplinary translational research designed to optimize symptom management are discussed.
authors.affiliation: Center for Research on Symptoms, Symptom Interactions, and Health Outcomes, USA. kpark04@emory.edu
authors.forename: Kathy P
authors.initials: KP
authors.lastname: Parker
authors.forename: Laura P
authors.initials: LP
authors.lastname: Kimble
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Dunbar
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Clark
mesh_terms: D016000:Cluster Analysis; D004777:Environment; D006694:Holistic Health; D006803:Human Development; D006801:Humans; D008954:Models, Biological; D016294:Models, Nursing; D008960:Models, Psychological; D009733:Nursing Diagnosis; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000150:complications* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D010348:Patient Care Team; D011788:Quality of Life; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology