The concept of symptom cluster.
OBJECTIVE
To define the concept of a symptom cluster, evaluate the evidence base in support of it, and address research and clinical implications.


METHODS
Review of descriptive research that examined fatigue, insomnia, pain, or depression in relation to other symptoms.


CONCLUSIONS
More investigation is needed. There is evidence of overlapping variance indicative of a relationship between or among symptoms. Few studies have addressed the outcomes of symptom clusters. There is limited evidence of symptom concurrence or a common biological pathway for clustered symptoms.


CONCLUSIONS
Consideration should be given to assessment and management of fatigue, insomnia, pain, and depression as potential "sentinel symptoms" that could affect patient outcomes.
Barsevick
Andrea M
AM
Nursing Research, Fax Chase Cancer Center, Philadelphia, PA, USA. Andrea.Barsevick@fccc.edu
D000701:Analgesics, Opioid / Q000009:adverse effects; D016000:Cluster Analysis; D019317:Evidence-Based Medicine; D006801:Humans; D009369:Neoplasms / Q000503:physiopathology*
D000701:Analgesics, Opioid