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Exploring symptom clusters in patients with lung cancer
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0001-5966-706X
2024 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis explored symptom clusters in patients with lung cancer before, during and after oncological treatment. A literature review and an interview study was used to explore the symptom cluster experience from the patients’ perspective. A large diversity of symptom cluster constellations were identified, in which fatigue was the most commonly occurring symptom, followed by dyspnea, pain, depression, cough and nutritional impact symptoms. Many symptom assessment instruments were identified, measuring mostly the intensity-dimension alone or in combination with timing. The results also stress that living with symptom clusters during treatment is more about survival than actually living. Patients’ symptom management strategies were shaped by impacting conditions such as knowledge and earlier experience of symptoms. Symptoms were often regarded as unavoidable by the patients and something to accept. How symptoms were recognized by health care professionals further added to the normalization of symptom clusters. Subsequently, patients would not always ask for support, and their quality of life was negatively affected. Holistic person-centered care including multi-dimensional symptom assessment is considered essential to ensure adequate symptom cluster management for patients with lung cancer.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2024. , p. 86
Series
Karlstad University Studies, ISSN 1403-8099 ; 2024:4
Keywords [en]
cancer care, oncology nursing, patients with lung cancer, patient-reported outcome measures, symptom assessment, symptom clusters, symptom management
National Category
Nursing Cancer and Oncology
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-98373ISBN: 978-91-7867-433-6 (print)ISBN: 978-91-7867-434-3 (electronic)OAI: oai:DiVA.org:kau-98373DiVA, id: diva2:1834672
Presentation
2024-03-22, Frödingsalen, 1B364, Karlstads universitet, Karlstad, 09:00 (Swedish)
Opponent
Supervisors
Funder
Region VärmlandAvailable from: 2024-03-01 Created: 2024-02-05 Last updated: 2025-02-18Bibliographically approved
List of papers
1. Exploring Symptom Clusters and Their Measurements in Patients With Lung Cancer: A Scoping Review for Practice and Research
Open this publication in new window or tab >>Exploring Symptom Clusters and Their Measurements in Patients With Lung Cancer: A Scoping Review for Practice and Research
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2023 (English)In: Oncology Nursing Forum, ISSN 0190-535X, E-ISSN 1538-0688, Vol. 50, no 6, p. 783-815Article, review/survey (Refereed) Published
Abstract [en]

PROBLEM IDENTIFICATION: This scoping review aimed to explore symptom clusters (SCs) in patients with lung cancer and how included symptoms and symptom dimensions are measured. LITERATURE SEARCH: PubMed®, CINAHL®, Scopus®, and Cochrane Library were searched for studies published until December 31, 2021. Fifty-three articles were included. DATA EVALUATION: Data extracted included descriptive items and SC constellations. Patient-reported outcome instruments and measured symptom dimensions were described according to the middle-range theory of unpleasant symptoms. SYNTHESIS: 13 articles investigated SCs a priori and 40 de novo. Thirty-six instruments were used, mostly measuring intensity alone or in combination with timing. Qualitative articles (n = 6) provided rich descriptions within the distress, timing, and quality dimensions. IMPLICATIONS FOR RESEARCH: Fatigue was the symptom found to most frequently co-occur with other symptoms in SCs. Fatigue, psychological symptoms, and nutritional aspects are emphasized as important areas for oncology nursing practice and further research to improve SC management for patients with lung cancer.

Place, publisher, year, edition, pages
Oncology Nursing Society, 2023
Keywords
lung cancer, patient-reported outcome instruments, symptom cluster, symptom dimensions
National Category
Nursing Cancer and Oncology
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-97562 (URN)10.1188/23.ONF.783-815 (DOI)001165020300001 ()37874760 (PubMedID)2-s2.0-85175741289 (Scopus ID)
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-03-08Bibliographically approved
2. To get through to survive: Exploring the symptom cluster management process during oncological treatment from the perspective of patients with lung cancer – A grounded theory study
Open this publication in new window or tab >>To get through to survive: Exploring the symptom cluster management process during oncological treatment from the perspective of patients with lung cancer – A grounded theory study
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2025 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 74, article id 102764Article in journal (Refereed) Published
Abstract [en]

Purpose: To explore the symptom cluster management process from the perspective of patients with lung cancer within the oncological care context. Methods: We used a constructivist grounded theory methodology to collect and analyze rich data from 15 patients with lung cancer via individual interviews and a two-dimensional symptom assessment scale. Results: A situational theoretical model describes the symptom cluster management process through the main category ‘To get through to survive’, with the category ‘Handling symptom clusters’ together with six sub-categories concerning the patients' management strategies and the category ‘Living with symptom clusters,’ together with two sub-categories describing the outcome in their daily life. Impacting conditions are incorporated in the model. Conclusions: Patients often feel left to their own devices to deal with symptom clusters and may not understand or foresee problematic circumstances as they manage their situations on a day-to-day basis. When symptoms are normalized and accepted, patients do not ask for support, or support is not being offered to them. Healthcare professionals should consider the peril of normalizing symptoms and the patients’ altered time perspective that stems from their approach of living one day at a time, in further development of nursing interventions and person-centered care for this population.

Place, publisher, year, edition, pages
Elsevier, 2025
Keywords
Adult, Delivery of health care, Grounded theory, Human, Lung Neoplasms, Oncology nursing, Situational theoretical model, Symptom clusters, Symptom management
National Category
Health Sciences Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-102615 (URN)10.1016/j.ejon.2024.102764 (DOI)001400154000001 ()2-s2.0-85212949895 (Scopus ID)
Funder
Region Värmland
Available from: 2025-01-03 Created: 2025-01-03 Last updated: 2025-02-18Bibliographically approved

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Karlsson, Katarina

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