title: Sickness behavior clustering in children with cancer.
abstract: Despite knowing that pediatric cancer patients experience multiple concurrent symptoms, most research focuses on individual symptoms. This study is a secondary data analysis from previous research evaluating symptom clusters and carnitine plasma levels in 67 children and adolescents aged between 7 and 18 years, before and after receiving ifosfamide, doxorubicin, or cisplatin chemotherapy. In preparation for cluster analysis, fatigue, nausea and vomiting, depression, and performance status symptoms were rated in categories of none, mild, moderate, or severe. A conceptual approach was used to evaluate the identification of unique patterns of symptoms that cluster as well as what subgroup members of pediatric oncology patients assemble together. Comparison of symptoms is made with the recent literature on sickness behavior symptoms. The hierarchical agglomerative cluster analysis was used to identify and classify variables into groups based on similarities they possess. This cluster analysis increases awareness of sickness behavior symptoms, patterns, interaction, and synergy. Increasing knowledge of the complex symptom experiences of pediatric oncology patients provides the scientific basis for new directions in symptom intervention.
authors.affiliation: Texas Children's Hospital, Houston, USA. mjhocken@txch.org
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Hockenberry
authors.forename: Mary C
authors.initials: MC
authors.lastname: Hooke
authors.forename: Kathy
authors.initials: K
authors.lastname: McCarthy
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Gregurich
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000187:drug effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002331:Carnitine / Q000097:blood; D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002945:Cisplatin / Q000009:adverse effects; D016000:Cluster Analysis; D003863:Depression / Q000139:chemically induced / Q000175:diagnosis; D004317:Doxorubicin / Q000009:adverse effects; D005221:Fatigue / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects; D055809:Illness Behavior; D017567:Karnofsky Performance Status; D008297:Male; D009325:Nausea / Q000139:chemically induced / Q000175:diagnosis; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000175:diagnosis; D014839:Vomiting / Q000139:chemically induced / Q000175:diagnosis
chemical_list: D000970:Antineoplastic Agents; D004317:Doxorubicin; D002945:Cisplatin; D002331:Carnitine; D007069:Ifosfamide