Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients

Aims and objectives: To explore the common symptom cluster in lung cancer patients with surgical treatment and to evaluate the relationships between symptom cluster and patients' disease outcomes, including functional status and quality of life.

Background: Lung cancer is one of the leading causes of cancer-related death for both men and women, and its incidence is increasing in China. Growing number of researches confirmed that symptoms in lung cancer patients with chemotherapy and radiotherapy occurred as 'symptom cluster' across the disease trajectory and influenced disease outcomes. However, few studies focused on the symptom cluster and its effects on quality of life and functional status of lung cancer surgery patients.

Design: This is a descriptive, cross-sectional design.

Methods: Symptoms in lung cancer surgery were assessed by M.D. Anderson Symptom Inventory, Karnofsky Performance Scale and Quality of Life Instruments for Cancer Patients - Lung Cancer. One hundred and forty-five individuals were involved in the survey.

Results: The top four common and most severe symptoms were pain, fatigue, disturbed sleep and distress for lung cancer surgery patients. 4·8% (n = 7) and 17·2% (n = 25) of patients reported co-occurrence of two or three symptoms of pain, fatigue, disturbed sleep and distress. About 76·6% (n = 111) of patients reported co-occurrence of all the four symptoms. There were strong negative relationships between the top four symptoms and Karnofsky Performance Scale and Quality of Life Instruments for Cancer Patients - Lung Cancer scores.

Conclusion: Pain, fatigue, disturbed sleep and distress constituted the common symptom cluster during the disease trajectory in patients with lung cancer who got surgical treatment and negatively affected their quality of life and functional status.

Relevance to clinical practice: Symptoms in lung cancer surgery patients often occurred as cluster during the trajectory of disease. To improve the well-being of patients, attentions need to be focused on developing symptom cluster management strategies.