Background and significance: Patients with lung cancer experience multiple symptoms, such as fatigue, insomnia, and depression during cancer therapy. In the past, studies on symptom management focused on individual symptoms. Recently, the concept of symptom cluster has gained attention in oncology research (Dodd et al., 2001). Understanding and treating symptoms as clusters may be more helpful in symptom management than treating an individual symptom in patients with lung cancer. Purpose: The purposes of this secondary data analysis were to investigate whether a cluster of symptoms can be identified in a group of patients with lung cancer and to test a mediation model of the impact of symptoms on functional status. Method: Data were obtained from a randomized clinical trial for patients with cancer-related fatigue. The baseline data of 63 patients with lung cancer were used in this secondary data analysis. After addressing the issue of missing data, correlation, factor analysis, and Sobel’s (1982) test for mediation effect were used for data analysis. Results: Fatigue was significantly correlated with depression (r=0.516, p < 0.001) and insomnia (r=0.328, p < 0.05). A single factor accounted for 51.26% of the variance of these three symptoms. In addition, fatigue mediates the effect of co-morbidities on functional status (Sobel’s test statistic=2.4, p < 0.016). Conclusion: The findings indicate that this group of patents with lung cancer experienced a cluster of symptoms that limit their functional status. Fatigue has a mediation effect on functional status. Relevance to nursing practice: These findings provide evidence for: (1) assessing co-morbidities and multiple symptoms when planning care for patients with lung cancer; and (2) planning nursing interventions directed at maintaining functional status by addressing the presenting symptom cluster.
Session #1185 - Oncology Nursing Research
The 29th Annual MNRS Research Conference (April 1-4, 2005)