Differences in composition of symptom clusters between older and younger oncology patients

Yates, Patsy, Miaskowski, Christine, Cataldo, Janine K., Paul, Steven M., Cooper, Bruce A., Alexander, Kimberly, Aouizerat, Bradley, Dunn, Laura, Ritchie, Christine, McCarthy, Alexandra, & Skerman, Helen (2015) Differences in composition of symptom clusters between older and younger oncology patients. Journal of Pain and Symptom Management, 49(6), pp. 1025-1034.

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Older oncology patients have unique needs associated with the many physical, psychological,and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences.


The purposes of this study were to identify and compare symptom clusters in younger (<60 years) and older ($60 years) patients undergoing cancer treatment. Methods. Symptom data from one Australian study and two U.S. studies were combined to conduct this analysis. A total of 593 patients receiving active treatment were dichotomized into younger (<60 years) and older ($60 years) groups. Separate exploratory factor analyses (EFAs) were undertaken within each group to identify symptom clusters from occurrence ratings of the 32 symptoms assessed by the Memorial Symptom Assessment Scale.


In both groups, a seven-factor solution was selected. Four partially concordant symptom clusters emerged in both groups (i.e., mood/cognitive, malaise, body image, and genitourinary). In the older patients, the three unique clusters reflected physiological changes associated with aging, whereas in the younger group the three unique clusters reflected treatment-related effects.


The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.

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2 citations in Web of Science®

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ID Code: 83692
Item Type: Journal Article
Refereed: Yes
Keywords: Symptom cluster, cancer, factor analysis
DOI: 10.1016/j.jpainsymman.2014.11.296
ISSN: 0885-3924
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2015 Elsevier
Deposited On: 20 Apr 2015 23:44
Last Modified: 23 Jul 2015 00:16

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