Symptom Clusters Trajectories and Influencing Factors in Patients With Head and Neck Cancer

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BACKGROUND: While head and neck cancer (HNC) patients often experience many concurrent symptoms, most research has focused on the assessment and management of individual, isolated symptoms. OBJECTIVE: The aim of this study was to investigate the longitudinal trajectories of symptom clusters in patients with HNC and analyze the predictive factors of each trajectory subgroup. METHODS: An exploratory factor analysis was conducted to analyze symptom clusters using the M. D. Anderson Symptom Inventory-Head and Neck in 218 HNC patients at 3 time points: during hospitalization, 1 month after discharge, and 3 months after discharge. The latent growth mixture modeling was used to identify the trajectory subgroups, and multinomial logistic regression was used to analyze the predictive factors of trajectory changes. RESULTS: The 4 symptom clusters were referred to as the mouth and throat symptom cluster, gastrointestinal symptom cluster, psychotherapeutic symptom cluster, and energy deficit symptom cluster. Three to 4 trajectory subgroups were identified in the symptom cluster using the latent growth mixture modeling. High-risk trajectory subgroups were influenced by female patients, low family per-capita monthly income, laryngeal cancer, high clinical staging, and age ( P < .05). CONCLUSIONS: Mouth and throat symptom cluster is unique to HNC. The high-risk trajectory categories are influenced by gender, family per-capita monthly income, tumor site, TNM clinical staging, and age. IMPLICATIONS FOR PRACTICE: Identifying high-risk trajectories and influencing factors of symptom clusters can help cancer caregivers in implementing individualized and tailored interventions.

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