Symptom Clusters Among Advanced Colorectal Cancer Patients Receiving Chemotherapy: an exploratory factor analysis

Abstract

Abstract Background Advanced Colorectal cancer patients receiving chemotherapy (AdCRCC) often experience suffering regarding many symptoms occurring simultaneously related to either cancer itself or chemotherapy or both. Currently, little is known about symptom clusters among these patients. Thus, the present study aimed to examine the symptom clusters across the two symptom dimensions of severity and distress among AdCRCC. Methods Three hundred twenty AdCRCC were recruited from five hospitals in Bangkok, Thailand, and selected based on inclusion criteria. Data were collected between August 2022 to January 2023 by using a demographic data form, the participants’ medical records, and the Memorial Symptom Assessment Scale (MSAS). Descriptive statistics and exploratory factor analysis (EFA) were used to analyze the data. Results The results showed the top five prevalent symptoms to be numbness/tingling in hands/feet, lack of energy, changes in skin, lack of appetite, and “I don’t look like myself.” The most frequent severity symptom was numbness/tingling in hands/feet, while difficulty sleeping was reported to be the most frequent distress symptom. There were five symptom clusters in the dimension of symptom severity, with a 38.474% variance in all the symptoms. These clusters were emotion-related symptoms; GI-, and fatigue-related symptoms; lack of appetite and difficulty sleeping–related symptoms; problems with sexual interest–related symptoms; and image-related cutaneous symptoms. There were five symptom clusters in the distress dimension, with 43.210% variance explained in all the symptoms. These clusters were emotion-related symptoms; lack of appetite and difficulty sleeping–related symptoms, problems with sexual interest–related symptoms; image- related cutaneous symptoms; and GI- and pain-related symptoms. Conclusions This study highlights important symptom cluster among AdCRCC. Understanding symptom clusters reported specifically among these patients may help healthcare providers to develop appropriate interventions for better symptom management for AdCRCC.