The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Symptom clusters in cancer patients
Abstract
Goals of work Cancer patients often experience multiple symptoms, many of which have been reported to correlate with each other. The goals of this study were to understand which cancer-related symptoms cluster together and to test the conceptual meanings of the revealed symptom clusters.Patients and methods Patients with various cancer diagnoses (N=151) were recruited from a medical center in northern Taiwan. The 13-item M.D. Anderson symptom inventory was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with oblique rotation. The known-group technique was used to validate the conceptual meanings of revealed factors.Main results Patients' symptom severity ratings fit a three-factor solution that explained 55% of the variance. These three factors (symptom clusters) were named sickness symptom cluster, gastrointestinal symptom cluster, and emotional symptom cluster. Patients with pain and with advanced diseases had significantly higher mean scores in the sickness symptom cluster than patients without pain and with earlier-stage diseases. The patients' functional status was negatively correlated with mean scores in the sickness symptom cluster. Patients under chemotherapy demonstrated significantly higher mean scores in the gastrointestinal symptom cluster than patients under other treatments. Patients with anxiety or depression also had significantly higher mean scores in the emotional symptom cluster than patients without anxiety or depression.Conclusions This study identified three underlying symptom clusters and verified their conceptual meaning in cancer patients. Knowing these symptom clusters may help healthcare professionals understand plausible mechanisms for the aggregation of symptoms.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“fatigue clusters with pain and sleep more commonly than with anxiety and depression.26,27”
From Mindfulness and Psychosocial Symptoms in People with Cancer: Testing Rumination and Experiential Avoidance as Mediators, and Sex as a Moderator. (2025) · cites this paper as [26]
Citations
Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152
The clinical evaluation of chemotherapeutic agents in cancer
Karnofsky, D. A. (1949) · Medical Entomology and Zoology · Cited by 2,933
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885
Biological basis of the behavior of sick animals
Hart, B. L. (1988) · Neuroscience & Biobehavioral Reviews · doi:10.1016/s0149-7634(88)80004-6 · Cited by 2,223
Making Sense of Factor Analysis
Pett, M., Lackey, N., & Sullivan, J. (2003) · doi:10.4135/9781412984898 · Cited by 2,168
Evaluation of Chemotherapeutic Agents.
(1950) · Archives of Internal Medicine · doi:10.1001/archinte.1950.00230180176018 · Cited by 1,134
Sickness behavior as a new target for drug development
Kent, S., Bluthé, R.-M., Kelley, K. W., & Dantzer, R. (1992) · Trends in Pharmacological Sciences · doi:10.1016/0165-6147(92)90012-u · Cited by 867
Cytokine-induced sickness behavior: where do we stand?
Dantzer, R. (2001) · Brain, Behavior, and Immunity · doi:10.1006/brbi.2000.0613 · Cited by 862
Development of a symptom distress scale
McCorkle, R. C., & YOUNG, K. (1978) · Cancer Nursing · doi:10.1097/00002820-197810000-00003 · Cited by 814
Symptom clusters and their effect on the functional status of patients with cancer.
Dodd, M. J., Miaskowski, C., & Paul, S. M. (2001) · PubMed · Cited by 775
Cytokine-induced sickness behavior
Kelley, K. W., Bluthé, R.-M., Dantzer, R., Zhou, J.-H., Shen, W.-H., Johnson, R. W., & Broussard, S. R. (2003) · Brain, Behavior, and Immunity · doi:10.1016/s0889-1591(02)00077-6 · Cited by 716
Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism?
Cleeland, C. S., Bennett, G. J., Dantzer, R., Dougherty, P. M., Dunn, A. J., Meyers, C. A., Miller, A. H., Payne, R., Reuben, J. M., Wang, X. S., et al. (2003) · Cancer · doi:10.1002/cncr.11382 · Cited by 528
Symptom Clusters: The New Frontier in Symptom Management Research
Miaskowski, C. A. (2004) · JNCI Monographs · doi:10.1093/jncimonographs/lgh023 · Cited by 405
Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease
McCorkle, R. C., & Quint-Benoliel, J. (1983) · Social Science & Medicine · doi:10.1016/0277-9536(83)90348-9 · Cited by 331
Given, C. W., Stommel, M., Given, B., Osuch, J., Kurtz, M. E., & Kurtz, J. C. (1993) · Health Psychology · doi:10.1037/0278-6133.12.4.277 · Cited by 325
Given, C. W., Stommel, M., Given, B. A., Osuch, J. R., Kurtz, M. E., & Kurtz, J. C. (1993) · Health Psychology · doi:10.1037//0278-6133.12.4.277 · Cited by 325
Occurrence of Symptom Clusters
Dodd, M. J. (2004) · JNCI Monographs · doi:10.1093/jncimonographs/lgh008 · Cited by 254
Symptom Clusters in Elderly Patients With Lung Cancer
Gift, A. G., Jablonski, A., Stommel, M., & Given, C. W. (2004) · Oncology nursing forum · doi:10.1188/04.onf.203-212 · Cited by 247
Symptom Clusters in Breast Cancer Across 3 Phases of the Disease
Bender, C. M., Erg??n, F. S., Rosenzweig, M. Q., Cohen, S. M., & Sereika, S. M. (2005) · Cancer Nursing · doi:10.1097/00002820-200505000-00011 · Cited by 194
Pain and Fatigue Management: Results of a Nursing Randomized Clinical Trial
Given, B. A., Given, C. W., McCorkle, R. C., Kozachik, S., Cimprich, B., Rahbar, M. H., & Wojcik, C. (2002) · Oncology nursing forum · doi:10.1188/02.onf.949-956 · Cited by 166
A Cluster of Symptoms Over Time in Patients With Lung Cancer
Gift, A. G., Stommel, M., Jablonski, A., & Given, C. W. (2003) · Nursing Research · doi:10.1097/00006199-200311000-00007 · Cited by 154
Prophylactic action of oral fluconazole against fungal infection in neutropenic patients
Kanda, Y., Yamamoto, R., Chizuka, A., Hamaki, T., Suguro, M., Arai, C., Matsuyama, T., Takezako, N., Miwa, A., Kern, W., et al. (2000) · Cancer · doi:10.1002/1097-0142(20001001)89:7 · Cited by 151
Dimensions of symptom distress in women with advanced lung cancer: a factor analysis.
Sarna, L., & Brecht, M. (1998) · Heart & lung : the journal of critical care · doi:10.1016/s0147-9563(97)90006-6 · Cited by 127
Armstrong, T. S., Cohen, M. Z., Eriksen, L. R., & Hickey, J. V. (2004) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.2004.04038.x · Cited by 121
Anxiety and depression in Taiwanese cancer patients with and without pain
Chen, M., Chang, H., & Yeh, C. (2000) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2000.t01-1-01560.x · Cited by 113
Self-citationDimensions of symptom distress in women with advanced lung cancer: a factor analysis.
Sama, L., & Brecht, M.-L. (1998) · Rehabilitation Oncology · doi:10.1097/01893697-199816030-00022 · Cited by 98
Physical symptom profiles of depressed and nondepressed patients with cancer
Chen, M., & Chang, H. (2004) · Palliative Medicine · doi:10.1191/0269216304pm950oa · Cited by 96
Self-citationSymptom Clusters in Elderly Patients With Lung Cancer
Gift, A. G., Jablonski, A., Stommel, M., & Given, C. W. (2004) · Clinical journal of oncology nursing · doi:10.1188/04.onf.202-212 · Cited by 53
Cutaneous fibrosis induced by docetaxel
Cleveland, M. G., Ajaikumar, B. S., & Reganti, R. (2000) · Cancer · doi:10.1002/(sici)1097-0142(20000301)88:5 · Cited by 48
Research works printed but not linked: 3
- Chang AP (2003) Development and validation of the Brief Fatigue Inventory–Taiwan form and M. D. Anderson symptom inventory–Taiwan form. Master thesis, Taipei Medical University
- Chiang CY, Chen ML, Yu WP, Huang TH (2001) Physical and psychological distress of brain tumor patients receiving radiotherapy. Chang Gung Nurs 12:271–281
- Lin LH (2000) Screening for depression in cancer inpatients. Master thesis, Chang Gung University
Cited by
Sorted by citations
Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis
Everdingen, M. H. J. V. D. B.-V., Hochstenbach, L. M. J., Joosten, E. A. J., Tjan‐Heijnen, V. C. G., & Janssen, D. J. A. (2016) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2015.12.340 · Cited by 1,671
“Response rate of less than 70% or not mentioned (5, 83-176)”
Elting, L. S., Cooksley, C. D., Chambers, M. S., & Garden, A. S. (2007) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2007.01.053 · Cited by 535
Ballesta, A., Innominato, P. F., Dallmann, R., Rand, D. A. J., & Lévi, F. (2017) · Pharmacological Reviews · doi:10.1124/pr.116.013441 · Cited by 348
Reilly, C. M., Bruner, D. W., Mitchell, S. A., Minasian, L. M., Basch, E., Dueck, A. C., Cella, D. F., & Reeve, B. B. (2013) · Supportive Care in Cancer · doi:10.1007/s00520-012-1688-0 · Cited by 301
The effect of symptom clusters on functional status and quality of life in women with breast cancer
Dodd, M. J., Cho, M. H., Cooper, B. A., & Miaskowski, C. A. (2009) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2009.09.005 · Cited by 291
“(Cleeland, Mendoza et al. 2000; Gift, Stommel et al. 2003; Wang, Tang et al. 2003; Gift, Jablonski et al. 2004; Wang, Wang et al. 2004; Chen and Tseng 2006; Wang, Laudico et al. 2006; Fan, Hadi et al. 2007; Gleason, Case et al. 2007; Chow, Fan et al. 2008; Hadi, Fan et al. 2008; Kim, Barsevick et…”
Background
Metadata
- Authors
- Chen, M.-L., & Tseng, H.-C.
- Affiliations
- Chang Gung University (TW)
- Koo Foundation Sun Yat-Sen Cancer Center (TW)
- Corresponding author
- Chen, Mei-Ling
- ORCID
- Chen, Mei-Ling
- Venue
- Supportive Care in Cancer
- Published
- 2006-02-21
- Volume
- 14
- Issue
- 8
- Pages
- 825-830
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W1996624485
- Cited by
- 159
- References
- 29
- Citations by year
- 2025: 6 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 6 · 2018: 1 · 2017: 14 · 2016: 9 · 2015: 5 · 2014: 7 · 2013: 12 · 2012: 15
- FWCI
- 6.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Chang Gung University
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- cancer symptoms, symptom clusters, symptom severity, gastrointestinal symptoms, emotional symptoms, pain, chemotherapy, anxiety, depression, functional status, disease stage, MD Anderson Symptom Inventory
- MeSH terms
- Activities of Daily Living, Adolescent, Adult, Aged, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Neoplasms, Quality of Life, Research Design, Severity of Illness Index, Taiwan, Multivariate Analysis, Cluster Analysis, Karnofsky Performance Status
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review