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A Symptom Cluster and Sentinel Symptom Experienced by Women With Lung Cancer

Jean K. Brown
Mary E. Cooley
Cynthia Chernecky
Linda Sarna
ONF 2011, 38(6), E425-E435 DOI: 10.1188/11.ONF.E425-E435

Purpose/Objectives: To determine the symptom experience and a sentinel symptom and to describe the relationship of participant characteristics with symptom clusters.

Design: Prospective, correlational study.

Setting: Clinical sites in five U.S. states.

Sample: 196 women six months to five years after non-small cell lung cancer diagnosis.

Methods: Symptoms were measured during the past day and past four weeks. Symptom clusters were described using a novel dummy coding approach.

Main Research Variables: Symptom occurrence and severity, demographic and clinical characteristics, health status factors, and meaning of illness.

Findings: About 98% of women experienced three or more symptoms in the past day. The most common symptoms reported by more than 80% of the women were fatigue, shortness of breath, anorexia, cough, and pain, with fatigue and shortness of breath rated as most severe. Sleep problems, concentration problems, and weight loss also were reported during the past four weeks. A five-symptom cluster including fatigue, shortness of breath, cough, pain, and anorexia was reported by 64% of women. Pain was identified as a sentinel symptom for that cluster.

Conclusions: Most women experienced at least three symptoms in the past day, and a five-symptom cluster occurred frequently and continued post-treatment.

Implications for Nursing: Women who participated in the study were, on average, two years postdiagnosis, but most experienced three or more symptoms well past treatment; therefore, vigilant ongoing clinical assessment of these women is essential. A co-occurring sentinel symptom used as a clinical indicator for the presence of a symptom cluster may be useful for clinical assessment.

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