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Eur J Oncol Nurs. 2005 Dec;9(4):325-33. Epub 2005 Nov 18.

A study to assess the existence of the symptom cluster of breathlessness, fatigue and anxiety in patients with advanced lung cancer.

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  • 1Nethersole School of Nursing, Chinese University of Hong Kong, Esther Lee Building, Shatin, New Territories, Hong Kong, Hong Kong.


The purpose of this small-scale study was to assess the existence of a symptom cluster involving breathlessness, fatigue and anxiety in patients with advanced lung cancer undergoing palliative radiation. A convenience sample of 27 patients were asked to complete a set of 100mm horizontal visual analogue scales (VAS) measuring the intensity of anxiety, breathlessness and fatigue at 3 points in time: 1 day prior to palliative radiotherapy (RT) (baseline, T0), and at week 3 (T1) and week 6 (T2) after the commencement of the RT. The prevalence of the 3 symptoms ranged from 59% to 96%. At baseline the median intensity of symptoms was mild, becoming progressively worse at T1 and T2. The correlations between the 3 symptoms were moderately strong at T1 and T2 (r=0.49-0.75). The proposed symptom cluster had high internal consistency across T0-T2. These data support the notion that the symptoms--breathlessness, fatigue, and anxiety--may be viewed as a symptom cluster. The high prevalence and moderate intensity of the symptom cluster demonstrates a need for an intervention to manage these symptoms simultaneously.

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