title: Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients.
abstract: OBJECTIVE
  To explore the common symptom cluster in lung cancer patients with surgical treatment and to evaluate the relationships between symptom cluster and patients' disease outcomes, including functional status and quality of life.
  
  
  BACKGROUND
  Lung cancer is one of the leading causes of cancer-related death for both men and women, and its incidence is increasing in China. Growing number of researches confirmed that symptoms in lung cancer patients with chemotherapy and radiotherapy occurred as 'symptom cluster' across the disease trajectory and influenced disease outcomes. However, few studies focused on the symptom cluster and its effects on quality of life and functional status of lung cancer surgery patients.
  
  
  METHODS
  This is a descriptive, cross-sectional design.
  
  
  METHODS
  Symptoms in lung cancer surgery were assessed by M.D. Anderson Symptom Inventory, Karnofsky Performance Scale and Quality of Life Instruments for Cancer Patients - Lung Cancer. One hundred and forty-five individuals were involved in the survey.
  
  
  RESULTS
  The top four common and most severe symptoms were pain, fatigue, disturbed sleep and distress for lung cancer surgery patients. 4·8% (n = 7) and 17·2% (n = 25) of patients reported co-occurrence of two or three symptoms of pain, fatigue, disturbed sleep and distress. About 76·6% (n = 111) of patients reported co-occurrence of all the four symptoms. There were strong negative relationships between the top four symptoms and Karnofsky Performance Scale and Quality of Life Instruments for Cancer Patients - Lung Cancer scores.
  
  
  CONCLUSIONS
  Pain, fatigue, disturbed sleep and distress constituted the common symptom cluster during the disease trajectory in patients with lung cancer who got surgical treatment and negatively affected their quality of life and functional status.
  
  
  CONCLUSIONS
  Symptoms in lung cancer surgery patients often occurred as cluster during the trajectory of disease. To improve the well-being of patients, attentions need to be focused on developing symptom cluster management strategies.
authors.affiliation: The Nursing College of Chongqing Medical University, Chongqing, China.
authors.forename: Shuanglan
authors.initials: S
authors.lastname: Lin
authors.forename: Yanhan
authors.initials: Y
authors.lastname: Chen
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.forename: Jianrong
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000209:etiology*; D013315:Stress, Psychological / Q000209:etiology*; D055815:Young Adult