ANALYSIS OF SYMPTOM CLUSTERS IN WOMEN WITH LUNG CANCER.

The purpose of this presentation is to demonstrate the use of a unique statistical approach to describe symptom clusters in a multi-site, prospective study of 196 women with nonsmall cell lung cancer who were > 6 months and < 5 years from diagnosis. Average age was 65.4 years (SD=11.4); average time since diagnosis was 24 months (SD=15.9). Most had adenocarcinoma and local or regional disease with surgical treatment. The conceptual framework posited that demographic, clinical, health status, and meaning of illness factors are related to symptom experience. Data for this correlational study were collected in Alabama, California, Georgia, Massachusetts, and New York by personal interview. Two reliable and valid measures were used to assess symptoms: the Lung Cancer Symptom Scale measured occurrence and severity during the past day, and the Symptom Query Questionnaire measured symptoms during the past 4 weeks. Analysis of symptom clusters began by creating a symptom cluster variable in which symptoms were uniquely coded. Cancer-related symptom clusters and their management are featured in the ONS Research Priorities and related to patient outcomes. Yet most researchers examined individual symptoms rather than symptom clusters, and most studies of symptom clusters were limited by secondary analyses of symptoms selected for primary studies and were analyzed using correlational techniques. Most previously used analytical methods described clusters based on relationships of severity of symptoms. In contrast, this analytical approach is an intuitively elegant method of describing the occurrence and severity of symptom clusters. Then frequency analysis of the new symptom cluster variable determined the occurrence of all clusters of co-occurring symptoms, and predominant clusters were identified. Boxplots were used to describe the severity of symptoms within clusters. 97.5% of the women experienced three or more symptoms in the past day. All but three of these women had symptom clusters including fatigue. The most commonly experienced symptom cluster (64%) during the past day included fatigue, shortness of breath, cough, pain, and anorexia with fatigue and shortness of breath being most severe. Although no predominant symptom cluster was identified for the past 4 weeks, 50% of the participants experienced three or more symptoms. Funding Sources: ONS Foundation [ABSTRACT FROM AUTHOR]