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Einfluss des „Schmerz-Schlafstörungen-Fatigue-Symptom Clusters“ auf die Funktionalität und den Gesundheitszustand von Krebspatienten. Eine sekundäre Datenanalyse.
Matthias Martin Gunga
Fördergeber - Sonstige;
Context: Cancer patients experience a variety of concurrent symptoms. These symptoms occur frequently in groups or clusters.
The intention of this analysis was to examine patterns of pain-insomnia-fatigue (PIF) symptom clusters over time and their impact on patients´ global health status and functionality.
Methods: 207 patients with diagnosed malignancy and pain >3 days and average pain ≥3/10 participated in a clinical trial in 2 German university hospitals. EORTC-QLQ C30 was used for patient reported symptom assessment. Symptom assessments were scheduled at trial inclusion until 28 days post discharge. The PIF - cluster conditions were fulfilled if a patient had each of the consisting symptom intensity score above the 30 out of 100 points threshold.
160 out of 207 patients (77.3%) showed a PIF - cluster at baseline. In this subpopulation 68 patients (42.5%) showed consistently stable PIF - clusters until 28 days post discharge. Thus, the PIF - cluster is a frequent and fairly stable symptom cluster in cancer patients with pain. Evaluating the impact of the PIF - cluster on global health status and on different functionality-scores the results reveal significant differences. Cracking a PIF - cluster is associated with a modest improvement of global health status, physical function and emotional function compared with a single symptom reduction.
Cracking a symptom cluster has a superior impact on the patients´ quality of life and functionality compared to single symptom reduction. Therefore treatment strategies are needed to address clusters of symptoms more comprehensively.


Cancer, fatigue, insomnia (syn. sleep disturbance), pain, symptom cluster

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