Correlation Study On Symptom Clusters And Dignity In Patients With Advanced Cancer

Objective: Patients with advanced cancer suffer from a wide range of physical and mental symptoms,these symptoms occurred with each other and constitute a symptom cluster.Since cancer is a multi-stage process involving multiple factors,the symptom cluster of cancer become more complex.Because of the interrelated effects of various symptoms within the symptom cluster,the quality of life is reduced,and the prognosis is seriously affected.While there is little research on the relationship between symptom clusters and dignity,this study was conducted to investigate symptoms in patients with advanced cancer,assess patient-reported symptom severity and clustering,and explore the relationship between symptom clusters and dignity among patients,optimizing the management of symptoms and providing personalized palliative care.Methods: We analyzed 193 patients data collected from the department of medical oncology of a three grade A class hospital from December 1st,2016 to January 31 st,2017,and were pathologically diagnosed as malignant tumor,including 48(24.9%)colorectal cancer,47(24.4%)lung cancer,41(21.2%)esophageal/ gastric cancer,19(9.8%)breast cancer,6(3.1%)ovarian cancer,and 32(16.6%)others.The general data of the patients were collected and the dignity and symptoms of the patients were investigated using the Patient Dignity Inventory(PDI)and Chinese version of M.D.Anderson Symptom Inventory(MDASI-C).Principal factor analysis was applied to extract the symptoms,and the correlations between the symptom clusters and all domains of dignity were analyzed by Pearson correlation analysis,and multiple linear regression analysis was used to evaluate the relationship between dignity and all aspects of symptom clusters.Results: The four most common symptoms of advanced cancer patients,ranked in order,were fatigue(92.2%),distress(84.5%),lack of appetite(79.8%),and dry mouth(78.2%).Fatigue was perceived to have the most severity,followed by lack of appetite,distress and disturbed sleep,of which fatigue is the most common and most severe symptom.The total score of the patient dignity inventory was 43.62±17.29,with the highest score of the symptom distress dimension being 12.14±4.72.Three symptom clusters were identified,that is psychosomatic symptom cluster,gastrointestinal symptom cluster,and general symptom cluster,and the severity of the three symptom clusters were positively correlated with dignity(P<0.05).Psychosomatic symptom cluster was main factors influencing the dignity of patients with advanced cancer(P<0.05).Conclusions: Patients with advanced cancer have a heavy burden of symptoms,a large number,and a high incidence.Not only do cancer patients experience a single symptom,many of them even experience complex symptom clusters;the degree of dignity lose in advanced patients is mainly mild to moderate.In clinical practice,attention to symptom clusters can provide individualized management for patients with advanced cancer,and more prospective and large sample study of single disease is expected to explore in the future.