title: [The evaluation of the symptom clusters in patients with the diagnosis of terminal stage cancer].
abstract: OBJECTIVE
  Palliative care has been developing rapidly throughout the world. A substantial number of palliative care patients are advanced cancer patients. Terminal cancer patients suffer from groups of symptoms called symptom clusters, rather than from individual independent symptoms. The aim of this study is to evaluate the symptoms of terminal cancer patients retrospectively and to present the symptom clusters of these patients.
  
  
  METHODS
  After ethical approval was obtained, a total of 113 (74 female, 39 male) patients with the diagnosis of the terminal stage cancer were retrospectively evaluated in Gaziosmanpasa University, Department of Anesthesiology and Reanimation between January 2011 and January 2013. Patient records were used to obtain medical history, physical examination findings, patient complaints, accompanying persons, primary cancer site, and metastasis sites. Symptoms such as fatigue, pain, vomiting, loss of appetite,insomnia, constipation, cough and dyspnea were assessed with the Edmonton Symptom Assessment System scale (0: None, 10: Worst possible). The symptom clusters were constructed using hierarchical symptom cluster analysis.
  
  
  RESULTS
  The mean age was 64.51 ± 11.38 years. Patients were referred to our outpatient clinic from Departments of General Surgery, Emergency Medicine, Urology, Oncology, Ear-Nose-Throat, Thoracic Surgery, Internal Medicine and Neurosurgery. Fatigue was the most-detected symptom (98.2%). Three symptom clusters were identified: nausea-vomiting-loss of appetite-constipation, dyspnea-cough, and fatigue-pain-insomnia.
  
  
  CONCLUSIONS
  Although palliative cancer patients were referred mainly with the symptom of pain, at least three symptom clusters were detected. The management of terminal stage cancer patients should focus on symptom clusters rather than individual symptoms.
authors: Department of Anesthesiology and Reanimation, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. mustafasuren@yahoo.com.
authors: Mustafa
authors: M
authors: Süren
authors: Department of Anesthesiology and Reanimation, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: Serkan
authors: S
authors: Doğru
authors: Department of Public Health, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: Yalçın
authors: Y
authors: Önder
authors: Department of Family Health, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: Nagihan
authors: N
authors: Yıldız Çeltek
authors: Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: İsmail
authors: İ
authors: Okan
authors: Department of Public Health, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: Rıza
authors: R
authors: Çıtıl
authors: Department of Anesthesiology and Reanimation, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: Serkan
authors: S
authors: Karaman
authors: Department of Emergency Medicine, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors: Nurşah
authors: N
authors: Başol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D010148:Intractable Pain / Q000209:etiology / Q000517:prevention & control*; D010166:Palliative Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013577:Syndrome