title: An investigation of a symptom cluster in Chinese patients with lung cancer receiving radiotherapy.
abstract: BACKGROUND
  The investigation of the clustering of symptoms in patients with cancer is still at an early stage. Initial evidence suggests symptoms such as breathlessness, fatigue and anxiety occur concurrently.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the existence of a symptom cluster involving breathlessness, fatigue and anxiety in Chinese patients with advanced lung cancer undergoing palliative radiotherapy (RT).
  
  
  METHODS
  The study was conducted in an oncology out-patient unit of a publicly funded hospital in Hong Kong. A convenience sample of 140 patients were asked to complete a set of questionnaires at four time points including the A-state scale of the State-Trait Anxiety Inventory, a breathlessness visual analog scale and the intensity subscale of the revised Piper Fatigue Scale at four points: 1 day prior to RT (baseline) (T0), and at week 3 (T1), week 6 (T2) and week 12 (T3) after the commencement of the RT.
  
  
  RESULTS
  Between 64-73% of patients experienced all three symptoms concurrently across T0-T3. The prevalence of anxiety, fatigue and breathlessness ranged from 65-97% respectively. Intensities of breathlessness and fatigue were highest at T1. Significant correlations between the three symptoms were moderate across time (r < 0.50).
  
  
  CONCLUSIONS
  The high prevalence of the symptom cluster demonstrates a need to assess and manage these symptoms simultaneously in patients with advanced lung cancer.
authors.affiliation: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR.
authors.forename: Carmen W H
authors.initials: CW
authors.lastname: Chan
authors.forename: Alison
authors.initials: A
authors.lastname: Richardson
authors.forename: Janet
authors.initials: J
authors.lastname: Richardson
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D005260:Female; D006723:Hong Kong; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged