Symptoms and Symptom Clusters in Adolescents Receiving Chemotherapy Treatment for Oncological Malignancy

Abstract

This descriptive study evaluated the symptoms and their clustering in adolescents undergoing chemotherapy for oncological malignancies. Conducted between December 2022 and December 2023, the study included 133 adolescents aged 10 to 18 years who were treated for cancer in the pediatric oncology unit of a university hospital in Turkey. Data analysis involved mean and percentage calculations, factor analysis, hierarchical clustering methods, dendrograms, and correlation analysis. The mean age of participants was 14.13 +/- 2.13 years, with 52.6% being male. The most frequently reported symptoms were lack of appetite (75.9%), feeling nervous (74.4%), and lack of energy (69.2%), while the least common symptoms included problems with urination (25.6%), constipation (22.6%), and swelling of the arms or legs (10.5%). Four distinct symptom clusters were identified: Cluster 1 included nausea, vomiting, pain, lack of appetite, lack of energy, and drowsiness; Cluster 2 encompassed dry mouth, irritability, sadness, and worry; Cluster 3 comprised changes in taste perception, altered self-image (I don't look like myself), weight loss, hair loss, skin changes, mouth sores, and nervousness; and Cluster 4 included diarrhea, itching, sweating, difficulty swallowing, urinary problems, insomnia, dyspnea, dizziness, limb swelling, constipation, and cough. The study highlighted that lack of appetite, feeling nervous, and lack of energy were the most prevalent symptoms and categorized symptoms into four distinct clusters, offering a framework for targeted nursing interventions. The identification of specific symptom clusters - ranging from gastrointestinal distress to emotional well-being - underscores the importance of cluster-based approaches in enhancing symptom management strategies.