• Catherine H Cherwin and Yelena Perkhounkova.
• University of Iowa College of Nursing, Iowa City, Iowa, USA. Electronic address: catherine-cherwin@uiowa.edu.
• J Pain Symptom Manage. 2017 Apr 1; 53 (4): 751-758.

Background/SignificancePeople 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.PurposeTo identify distress-based GI symptom clusters and to investigate their relationship to symptom interference with daily life and quality of life (QoL).SubjectsAbout 105 adults with hematologic malignancy receiving chemotherapy.MethodsOn 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.ResultsOf 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.ConclusionsThis 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.Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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