The Study Of Symptom Clusters And Their Factors Among Head And Neck Cancer Patients During The Treatment

Objectives To identify symptom clusters(SCs) among head and nec k cancer (HNC) patients during the treatment, as well as the factors aff ecting the SCs.Methods The M.D. Anderson Symptom Inventory-Head & Neck (MDASI-H&N) was applied to measure the treatment-related symptoms among 247 HNC in patients who were getting treated in the oncology department, the oral and maxillofacial surgery department and the otolar yngological department of the first affiliated hospital of Chongqing med ical university and the laryngeal, head and neck department of the first affiliated hospital of Zhengzhou university from December 2013 to July 2014.In the current study, all of the data was analyzed by SPSS 17.0 so ftware package. Descriptive analysis was used to described the demogra phic and disease characteristics of HNC patients, incidence and severity of symptoms experienced by HNC patients. Factor analysis was used t o identify the HNC SCs. Cronbach’s a coefficients were used to assess the internal consistency of the SCs. Spearman correlation analysis was used to explore the correlations among the symptoms within SCs. Univ ariate analysis and multiple linear regression analysis were used to expl ore the factors affecting the 5 SCs.Results 5 SCs were identified, including two HNC specific cluste rs chemoradiotherapy (CRT) related cluster and the dysfunction cluster, gastrointestinal sickness cluster, psychological cluster and nervous syste m cluster. The Cronbach’s a coefficients of symptom clusters were 0.89 7,0.928,0.853,0.815 and 0.662 respectively. The Spearman correlation analysis revealed that all symptom items within the 5 SCs are positive related (r=0.228-0.856, all P=0.000<0.001).Multiple linear regression analysis proved that cancer stage showed significant effect on CRT related SC and explained variance of 14%. T reatment, stoma of laryngeal and tube feeding showed significant effect s on the HNC dysfunction SC and explained variance of 68.4%. Tobacc o accounted for the variance of 10.1% of the gastrointestinal sickness c luster. Cancer site and stoma of laryngeal showed significant effects on the psychological cluster and explained the variance of 11.7%. Univaria te analysis proved that stoma of laryngeal showed effect on the nervous system cluster.Conclusions 5 HNC SCs among HNC patients during the treatmen t were confirmed in the current study, which have brought serious burd ens to the functions of physiology, psychology and society of the HNC patients. The current study provided preliminary support for the further study of SCs among HNC patients. These results may be helpful for t he clinical symptom and SCs management. Moreover, the further resear ches are necessary to examine the generalizability and particularity of i dentified clusters and to understand the underlying mechanisms of SCs, providing scientific theory to understand and manage SCs better.