title: Symptom clusters in children with cancer.
abstract: OBJECTIVE
  To discuss the symptoms of fatigue, sleep disturbance, and pain in children undergoing cancer treatment, and a framework for the clustering of these symptoms.
  
  
  METHODS
  Published articles, research studies, and clinical experience.
  
  
  CONCLUSIONS
  Symptoms experienced by children undergoing cancer treatment are distressing, prevalent, and rarely occur in isolation. Multiple symptoms may share underlying mechanisms, influence the severity of the distress experienced, and interfere with a child's ongoing development. Developing knowledge of the relationships among symptoms may be important for improving quality of life during cancer treatment while supporting the child's development.
  
  
  CONCLUSIONS
  Nurses must be aware of the symptom distress occuring in children with cancer to manage its symptoms and its treatments.
authors.affiliation: Center for Research and Evidence-Based Practice, Texas Children's Hospital, Houston, TX, USA. mjhocken@txccc.org
authors.forename: Marilyn
authors.initials: M
authors.lastname: Hockenberry
authors.forename: Mary C
authors.initials: MC
authors.lastname: Hooke
mesh_terms: D000203:Activities of Daily Living; D002648:Child; D016000:Cluster Analysis; D005221:Fatigue / Q000503:physiopathology; D017144:Focus Groups; D006801:Humans; D001523:Mental Disorders; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000503:physiopathology