Symptom clusters and related factors in bladder cancer patients three months after radical cystectomy.
BACKGROUND
To identify symptom distress and clusters in patients 3 months after radical cystectomy and to explore their potential predictors.


METHODS
A cross-sectional design was used to investigate 99 bladder cancer patients 3 months after radical cystectomy. Data were collected by demographic and disease characteristic questionnaires, the symptom experience scale of the M.D. Anderson symptom inventory, two additional symptoms specific to radical cystectomy, and the functional assessment of cancer therapy questionnaire. A factor analysis, stepwise regression, and correlation analysis were applied.


RESULTS
Three symptom clusters were identified: fatigue-malaise, gastrointestinal, and psycho-urinary. Age, complication severity, albumin post-surgery (negative), orthotropic neobladder reconstruction, adjuvant chemotherapy and American Society of Anesthesiologists (ASA) scores were significant predictors of fatigue-malaise. Adjuvant chemotherapy, orthotropic neobladder reconstruction, female gender, ASA scores and albumin (negative) were significant predictors of gastrointestinal symptoms. Being unmarried, having a higher educational level and complication severity were significant predictors of psycho-urinary symptoms. The correlations between clusters and for each cluster with quality of life were significant, with the highest correlation observed between the psycho-urinary cluster and quality of life.


CONCLUSIONS
Bladder cancer patients experience concurrent symptoms that appear to cluster and are significantly correlated with quality of life. Moreover, symptom clusters may be predicted by certain demographic and clinical characteristics.
['Ren|Hongyan|H|', 'Tang|Ping|P|', 'Zhao|Qinghua|Q|', 'Ren|Guosheng|G|']
D003430:Cross-Sectional Studies D015653:Cystectomy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D011183:Postoperative Complications D013577:Syndrome D013997:Time Factors D001749:Urinary Bladder Neoplasms
Symptom cluster Bladder cancer Radical cystectomy Symptom distress Quality of life