title: Distress-Based Gastrointestinal Symptom Clusters and Impact on Symptom Interference and Quality of Life in Patients with a Hematologic Malignancy Receiving Chemotherapy.
abstract: People with cancer can experience co-occurring related symptoms, labeled symptom clusters. Gastrointestinal (GI) symptoms are common side effects of chemotherapy, but little research has investigated GI symptom clusters. A further gap in symptom cluster research is the lack of studies reporting symptom clusters based on symptom distress ratings.
  
  
  
  To identify distress-based GI symptom clusters and to investigate their relationship to symptom interference with daily life and quality of life (QoL).
  
  
  
  About 105 adults with hematologic malignancy receiving chemotherapy.
  
  
  
  On Day 1 of a cycle of chemotherapy, participants completed a modified version of the Memorial Symptom Assessment Scale assessing 30 clinically relevant symptoms, the M.D. Anderson Symptom Inventory Symptom Interference with Daily Life subscale, and the Fox Simple Quality of Life Scale. Exploratory factor analysis was used to identify distress-based symptom clusters. Symptom clusters with ≥50% GI symptoms were labeled GI symptom clusters. Linear mixed modeling explored relationships between GI symptom clusters and symptom interference with daily life and QoL.
  
  
  
  Of the six distress-based symptom clusters found, the bloating cluster and appetite cluster were identified as GI symptom clusters. Both the bloating cluster and the appetite cluster were significantly related to symptom interference with daily life, but only the appetite cluster was significantly related to QoL.
  
  
  
  This research demonstrates the existence of distress-based GI symptom clusters and their relationship to symptom interference and QoL. Future work should explore predictors of distress-based symptom clusters and interventions to manage them.
authors.affiliation: University of Iowa College of Nursing, Iowa City, Iowa, USA. Electronic address: catherine-cherwin@uiowa.edu.
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Cherwin
authors.affiliation: University of Iowa College of Nursing, Iowa City, Iowa, USA.
authors.forename: Yelena
authors.initials: Y
authors.lastname: Perkhounkova
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005163:Factor Analysis, Statistical; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological / Q000209:etiology* / Q000503:physiopathology; D013577:Syndrome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Hematologic malignancy; gastrointestinal; quality of life; symptom cluster; symptom distress; symptom interference