title: Symptom clustering in older Taiwanese children with cancer.
abstract: OBJECTIVE
  To derive symptom clusters occurring in a large group of older pediatric patients with cancer in Taiwan and to examine whether each cluster differed based on gender, type of cancer and disease, pain, and functional status.
  
  
  METHODS
  Descriptive, correlational study.
  
  
  METHODS
  Pediatric oncology inpatient unit and outpatient clinics in Taiwan.
  
  
  METHODS
  144 pediatric patients with cancer, aged 10-18 years.
  
  
  METHODS
  Subjects completed the Memorial Symptom Assessment Scale 10-18, the Play Performance Scale for Children, and a demographic questionnaire. Medical records provided disease and treatment data. Cluster analysis techniques were used to identify the symptoms that clustered together by demographic characteristics, as well as disease, pain, and functional status.
  
  
  METHODS
  Symptom cluster, pain status, and functional status.
  
  
  RESULTS
  Five clusters were identified from the statistical analysis. The symptoms that clustered together were somewhat surprising, and some can be explained by cultural differences. Patients with pain reported statistically significant higher distress in all five clusters.
  
  
  CONCLUSIONS
  Five symptom clusters are identified in older Taiwanese children with cancer. The way and possible rationale of how these symptoms clustered together is discussed.
  
  
  CONCLUSIONS
  This is the first study that used a statistical procedure to derive symptom clusters experienced by pediatric oncology patients. Knowledge from this study can provide a starting point to investigate the stability of symptom clusters with different states of disease, different populations, and over various periods of time.
authors.affiliation: School of Nursing at Chang Gung University, Tao-Yuan, Taiwan. cyeh@mail.cgu.edu.tw
authors.forename: Chao-Hsing
authors.initials: CH
authors.lastname: Yeh
authors.forename: Yi-Chien
authors.initials: YC
authors.lastname: Chiang
authors.forename: Lung-Chang
authors.initials: LC
authors.lastname: Chien
authors.forename: Lin
authors.initials: L
authors.lastname: Lin
authors.forename: Chao-Ping
authors.initials: CP
authors.lastname: Yang
authors.forename: Huo-Li
authors.initials: HL
authors.lastname: Chuang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D016000:Cluster Analysis; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology